Editor’s Note: The 66th American Society of Hematology (ASH) Annual Meeting was held from December 7–10, 2024, in San Diego, USA. As one of the world's largest international academic conferences in the field of hematology, ASH brings together cutting-edge research and the latest drug development data, showcasing the highest level of global hematology research. During this event, Dr. Kai Hu, Director of the Lymphoma and Myeloma Department at Beijing GoBroad Boren Hospital, had multiple studies (abstracts 3079, 3387, and 1745) selected for presentation, focusing on CAR-T therapy in lymphoma and myeloma. Oncology Frontier – Hematology Frontier invited Professor Hu to share in-depth insights and analyses on these studies.

Abstract 3079

Treatment Outcomes in Patients with Relapsed/Refractory Central Nervous System Lymphoma (R/R-CNSL) in the Era of Chimeric Antigen Receptor T Cell (CAR-T) Therapy

Hematology Frontier：Could you talk about the importance of bridge debulking therapy based on this study? What implications does this study bring to the clinic for R/R CNSL patients who are effective and ineffective in bridge therapy, respectively?

Dr. Kai Hu: For patients with relapsed/refractory central nervous system lymphoma (R/R-CNSL), subsequent treatment is tricky and difficult. In this study, we adopted salvage debulking therapy, and then divided the patients into debulking therapy-sensitive group and debulking therapy-insensitive group according to the efficacy of debulking therapy. It is worth pointing out that the efficacy of debulking therapy has indicative and guiding significance for the choice of subsequent treatment plans: ①For patients who are effective in debulking therapy, we believe that they are not completely resistant to chemotherapy and can achieve long-term remission through further chemotherapy or ASCT. If the depth of patient’s remission is not enough, CAR-T therapy can be added to improve the efficacy. ②However, for patients who are ineffective in debulking therapy, it indicates that they have fully developed resistance to chemotherapy. It is expected that the efficacy of continuing to use chemotherapy as subsequent treatment will be poor. We more recommend radiotherapy + CAR-T as the subsequent treatment option to achieve long-term survival for patients.

In summary, for R/R-CNSL patients, debulking therapy is not only a treatment method, but also brings guidance for the choice of subsequent treatment modes. This study just elaborates on this topic.

Abstract 3387

Efficacy and Safety of BCMA-CAR-T Cell Therapy in Relapsed/Refractory Extramedullary Plasmacytoma (EMP): Exploring the Role of Consolidation Therapy

Hematology Frontier：How can we evaluate the overall efficacy and safety of BCMA CAR-T treatment for relapsed/refractory extramedullary plasmacytoma (R/R EMP)? In the exploration of BCMA CAR-T treatment for R/R EMP, what clinical value and significance does consolidation therapy show?

Dr. Kai Hu: In terms of BCMA CAR-T treatment for EMP, the current consensus is that it has certain efficacy, but the depth of remission is insufficient, and the duration of efficacy is relatively short. In this study, relatively rare relapsed/refractory EMP (R/R-EMP) patients were included. After BCMA-CAR-T treatment, active maintenance therapy was carried out, including hematopoietic stem cell transplantation (especially allo-HSCT), targeted drug maintenance therapy, and local radiotherapy. The results showed that BCMA CAR-T monotherapy had a general efficacy for R/R-EMP, with insufficient depth of remission. Only subsequent bridge consolidation therapy (especially allo-HSCT) could achieve better long-term survival. This also suggests that for R/R-EMP patients, BCMA CAR-T followed by bridge consolidation therapy is a recommended treatment strategy, which can achieve better long-term survival.

Abstract 1745

The Clinical Value of Prognostic Nutritional Index (PNI) in CAR-T Therapy for Patients with Malignant Lymphoma

Hematology Frontier：At this ASH meeting, your team explored the clinical value of the prognostic nutritional index (PNI) in patients with malignant lymphoma receiving CAR-T therapy from a nursing perspective. Could you please interpret this for us?

Dr. Kai Hu: Nursing work is an important part of our medical team. For the management of complex hematological tumors, our nursing team has done a lot of effective work and also carried out in-depth research. This study mainly explored the impact of nutritional status (prognostic nutritional index, PNI) on the prognosis of relapsed/refractory malignant lymphoma patients receiving CAR-T therapy. In addition, the researchers of our nursing team are also committed to the nutritional assessment of patients, the assessment of quality of life (QoL), the nursing of complex wounds, and the follow-up of patients. The collaboration between medical and nursing staff runs through clinical work and research. The management of relapsed/refractory hematological malignancies is an important part, which has played the respective advantages of medical and nursing staff and provided better treatment for patients.

Hematology Frontier：Can you talks about your team’s plans in the exploration of CAR-T therapy for lymphoma and myeloma?

Dr. Kai Hu: Our center mainly focuses on the treatment of relapsed/refractory lymphoma or myeloma patients. CAR-T is a very important treatment for such patients. Of course, there will be more new therapies in the future, including bispecific antibodies and new targeted drugs. With the emergence of many new drugs, exploring better combination treatment modes and bringing longer PFS and OS to patients is the direction of our team’s future research. In addition, we will focus on new target CAR-T, universal CAR-T, CAR-T bridging treatment with transplantation, central nervous system lymphoma (CNSL), relapsed/refractory multiple myeloma (RRMM), and CAR-T treatment for autoimmune diseases, and will carry out more clinical trials for exploration.

Dr. Kai Hu

• Chief Physician, MD, Director of Lymphoma and Myeloma, Beijing GoBroad Boren Hospital
• Nearly 20 years in hematologic oncology specializing in leukemia, lymphoma, and multiple myeloma treatment, including CAR-T, CIK/NK immunotherapy, targeted therapy, and stem cell transplantation.
• Pioneer in CAR-T therapy for CNS lymphoma and post-CD19 CAR-T relapse.
• Led nearly 40 clinical trials, contributing to over 100 studies, and published more than 40 research papers.
• Active in numerous national and international hematology societies.