Chimeric Antigen Receptor T-Cell Therapy for Refractory Multiple Myeloma: A Twenty Four Month Prospective Cohort: Response Rates, Toxicity Profile, and Predictors of Durable Remission

Dr. Ankit Paliwal, Ritu Verma, Dr. Rashmi Sharma

Multiple Myeloma; CAR-T Cell Therapy; BCMA; Cytokine Release Syndrome; ICANS; Relapsed Refractory; Idecabtagene; Ciltacabtagene.

Chimeric antigen receptor T-cell (CAR-T) therapy targeting B-cell maturation antigen (BCMA) has transformed the treatment of relapsed/refractory multiple myeloma, producing unprecedented response rates in patients with otherwise treatment-resistant disease. Real-world outcomes data from South Asian populations remain limited. We prospectively followed 164 patients infused with anti-BCMA CAR-T therapy (idecabtagene vicleucel or ciltacabtagene autoleucel) at a tertiary cancer centre between 2022 and 2024 over 24 months. Overall response rate was 86.6% with complete or stringent complete response in 35.4%. Median progression-free survival was 11.6 months and 12-month overall survival was 76%. Cytokine release syndrome occurred in 76.8% (grade ≥3 in 13.4%) and ICANS in 37.8% (grade ≥3 in 7.3%). Strongest independent predictors of durable response included achievement of sCR/CR at 3 months, ≤3 prior lines of therapy, absence of extramedullary disease, standard-risk cytogenetics, and high BCMA expression pre-infusion. The findings reproduce trial-level effect sizes in a real-world setting while highlighting infrastructure, cost, and toxicity-management demands of CAR-T programmes.

[1] Agarwal, A., Kumar, D., & S, P. M. (2026). Optimizing clinical effectiveness of enhanced recovery after surgery (ERAS): Multidisciplinary pathways, patient-centered outcomes, and data-driven performance analytics. International Innovations & Scholarly Trends Journal, 2(2).
[2] Agarwal, P., Khatoon, N., & Kumar, A. (2026). Infection control and implant survival in orthopaedic surgery: Evidence-based strategies, antimicrobial innovation, and digital surveillance. International Journal of Scientific Research in Engineering and Management, 10(03).
[3] Ahluwalia, M. G. C. S., Gupta, S. K., & Chaudhary, A. (2026). Precision-oriented hemodynamic monitoring in critical care practice: Evidence-based strategies, clinical integration, and outcome optimization. International Journal of Scientific Research and Technology.
[4] Ashifa, K. M. (2022). A situation analysis of the social well-being of elderly during the COVID-19 pandemic. International Journal of Health Sciences, 6(3), 10156–10163.
[5] Aumose, L., & Raj, M. A. (2026). Applications of intelligent motion control systems in promoting mental health and human-centered support for higher secondary students. In Intelligent motion control for human-centered systems (pp. 127–152). IGI Global.
[6] Bhatia, R., Shivakumar, R. M., & Kumar, N. (2026). Determinants of functional recovery and health-related quality of life following total hip and knee arthroplasty. International Journal of Recent Development in Engineering and Technology, 15(3).
[7] Bhatnagar, M., Kumar, N., & Shivam. (2026). Quality improvement frameworks in modern surgical practice: Evidence-based models, implementation science, and outcome-oriented performance evaluation. International Journal of Scientific Research and Engineering Development, 9(2).
[8] Bhatnagar, V., Tyagi, N., & John, L. (2026). Simulation-based competency development in anesthesia training: Educational theory, assessment validity, and clinical impact. International Journal of Versatile Research and Analysis, 4(2).
[9] Catherine, S., Gupta, N., Gopi, E., & Swadhi, R. (2025). Enhancing patient engagement and outcomes through digital transformation: Machine learning in medical marketing. In Impact of digital transformation on business growth and performance (pp. 285–312). IGI Global.
[10] Catherine, S., Nasrin Sulthana, M., Manimaran, M., Praba Devi, P., & Akila, R. (2026). Cyber-physical systems and cloud robotics for global supply chain resilience. In Methodologies and applications of intelligent motion control systems (pp. 133–158). IGI Global.
[11] Deepa, R., Swadhi, R., Udayavani, V., Lakshmi, R., & Rafiq, S. (2026). Motion-controlled wearables for physiological monitoring and predictive diagnostics. In R. Vettriselvan & N. Suresh (Eds.), Intelligent motion control for human-centered systems (pp. 1–28). IGI Global.
[12] Devi, M., Manokaran, D., Sehgal, R. K., Shariff, S. A., & Vettriselvan, R. (2025). Precision medicine, personalized treatment, and network-driven innovations: Transforming healthcare with AI. In AI for large scale communication networks (pp. 303–322). IGI Global.
[13] Durgia, B., Kumar, P., & Neha. (2026). Comparative clinical effectiveness and long-term functional outcomes of conservative versus surgical management in degenerative and compressive spinal disorders. International Journal of Scientific Research in Engineering and Management, 10(03).
[14] Gautam, M., Samyal, M., & Chaudhary, S. (2026). Preoperative risk stratification and surgical outcome prediction: Integrating clinical scoring systems, data-driven models, and patient-centered optimization. International Innovations & Scholarly Trends Journal, 2(3).
[15] Gupta, O. P., Gautam, S., & Maitiy, S. (2026). Management strategies for degenerative musculoskeletal disorders: An integrated clinical and technological framework. International Journal of Recent Development in Engineering and Technology, 15(3).
[16] Jagar, K. D., Kumar, A., & Yadav, A. (2026). Multimodal analgesia in acute and chronic pain management: Mechanistic rationale, clinical applications, and outcome-focused strategies. Journal of Advanced Academic Research and Findings, 4(2).
[17] Jenifer, R. D., Vettriselvan, R., Saxena, D., Velmurugan, P. R., & Balakrishnan, A. (2025). Green marketing in healthcare advertising: A global perspective. In AI impacts on branded entertainment and advertising (pp. 303–326). IGI Global.
[18] Jha, S. C., Kumar, P., & Neha. (2026). Artificial intelligence-assisted decision support in internal medicine: Enhancing clinical judgment, precision care, and health system performance. International Journal of Scientific Development and Research, 11(2).
[19] Kumar, A., Kumar, N., & Dhabhai, M. (2026). Optimizing outcomes through evidence-based protocols in postoperative intensive care: Clinical standards, implementation strategies, and quality improvement. International Journal of Scientific Research and Technology.
[20] Kumar, P., Gautam, S., & Maitiy, S. (2026). Diagnostic utility of biomarkers in early disease stratification: Clinical applications, predictive value, and emerging innovations. Journal of Emerging Technologies and Innovative Research, 13(2).
[21] Kumar, R., Sharma, K., & Gupta, S. K. (2026). Multimorbidity patterns and therapeutic complexity in adult medical practice: Implications for polypharmacy and patient-centred care. International Journal of Creative Research Thoughts, 14(2).
[22] Kumar, S., Kumar, V., & Tomer, H. (2026). Evolution of minimally invasive surgical techniques and clinical outcomes: Technological progress, specialty-specific adoption, and outcome-oriented evidence. Asian Journal of Multidimensional Research.
[23] Lal, S. K., Vaibhav, & Khursheed, M. (2026). Anesthetic management in geriatric and comorbid patients: Clinical challenges, risk stratification, and outcome-oriented strategies. International Innovations & Scholarly Trends Journal, 2(2).
[24] Lodha, V., Sharma, K., & Saraswat, P. (2026). Role of structured multidisciplinary rehabilitation in optimizing functional recovery and long-term outcomes in musculoskeletal disorders. International Journal of Scientific Research in Engineering and Management, 10(03).
[25] Mishra, A., Choudhary, A., & Kumar, S. (2026). Infection prevention strategies in operative care: Evidence-based interventions, systems integration, and outcome-oriented practice. Asian Journal of Multidimensional Research.
[26] Mustafa, N., Zahoor, H., Gamil, R. E., Ashifa, K. M., & Safaei, M. (2026). Empowering future caregivers: The role of self-leadership in reducing stress among nursing students. International Journal of Innovation and Learning, 39(1), 74–103.
[27] Natarajan, P., Saravanan, A., Krishnakumar, B., Chandralekha, V., & Suresh Kumar, A. (2026). Motion control strategies in assistive devices for elderly and differently-abled patients. In Intelligent motion control for human-centered systems (pp. 103–126). IGI Global.
[28] Pavithra, M. R., Chitra, V., Subhashini, V., Hemalatha, D., & Kiran, S. R. (2026). Intelligent prosthetics motion learning and neuro-muscular feedback integration. In Intelligent motion control for human-centered systems (pp. 77–102). IGI Global.
[29] Pradeepa, S. V., Gokilavani, R., Deepan, A., Sridevi, J., & Selvi, K. (2026). Predictive maintenance and asset management using motion analytics. In Methodologies and applications of intelligent motion control systems (pp. 75–104). IGI Global.
[30] Rani, A., & Tyagi, N. (2026). Osteoporosis risk assessment and preventive interventions: Evidence-based screening, predictive modelling, and community-level strategies. International Journal of Recent Development in Engineering and Technology, 15(3).
[31] Rasi, R. A., & Ashifa, K. M. (2019). Role of community-based programmes for active ageing: Elders self-help group in Kerala. Indian Journal of Public Health Research & Development, 10(12).
[32] Sahu, R. L., Sharma, K., & Gupta, S. K. (2026). Biological and mechanical determinants of fracture healing: An integrated mechano-biological, systemic, and translational framework. International Journal of Recent Development in Engineering and Technology, 15(3).
[33] Sehgal, A., Jayapriya, R., & Kumar, A. (2026). Evidence-based rehabilitation in sports-related injuries: Clinical effectiveness, multidisciplinary integration, and technological advancements. International Journal of Recent Development in Engineering and Technology, 15(3).
[34] Selvi, K., Anbarasan, P., Madhumita, G., Janaki, L., & Devi, K. K. (2026). Governance, security, and ethical considerations in AI-driven motion control systems. In Methodologies and applications of intelligent motion control systems (pp. 217–242). IGI Global.
[35] Shanthi, H. J., Gokulakrishnan, A., Sharma, S., Deepika, R., & Swadhi, R. (2025). Leveraging artificial intelligence for enhancing urban health: Applications, challenges, and innovations. In Nexus of AI, climatology, and urbanism for smart cities (pp. 275–306). IGI Global.
[36] Sharma, S., Sharma, K., & Tyagi, N. (2026). Geriatric psychiatry and cognitive decline: Clinical evaluation, neuropsychological determinants and evidence-based management. International Journal of Management Research and Social Science, 13(2).
[37] Singh, S., Chauhan, Y., & Kumar, D. (2026). Biomechanical innovations in orthopaedic implant design: Materials science, AI-assisted customization, and smart integration. International Journal of Scientific Research in Engineering and Management, 10(03).
[38] Singhal, A., Kumar, A., & Kataria, N. (2026). Advances in wound healing and tissue regeneration: Biomaterials, regenerative strategies, and translational challenges. International Innovations & Scholarly Trends Journal, 2(2).
[39] Subramani, M., Chillagattu, V., Gayathri, K., Rastogi, V., & Ranganathan, S. (2026). Digital twin integration for predictive and real-time motion control in infrastructure engineering. In Methodologies and applications of intelligent motion control systems (pp. 189–216). IGI Global.
[40] Suresh, N. V., Hemalatha, S., Lakshmi, S. J., Mounica, C., & Kalaivani, M. (2026). AI-enabled motion control in surgical robotics: Precision, dexterity, and real-time adaptation. In Intelligent motion control for human-centered systems (pp. 29–50). IGI Global.
[41] Swadhi, R., Gayathri, K., Suresh, N. V., Catherine, S., & Velmurugan, P. R. (2025). Leveraging machine learning for enhanced patient engagement and outcomes: Revolutionizing healthcare marketing. In Impact of digital transformation on business growth and performance (pp. 313–340). IGI Global.
[42] Venice, A., Swadhi, R., Gayathri, K., Chandra, P., & Sajana, K. P. (2026). Rehabilitation robotics and adaptive motion planning for patient-centric care. In R. Vettriselvan & N. Suresh (Eds.), Intelligent motion control for human-centered systems (pp. 51–76). IGI Global.
[43] Vettriselvan, R., Ramya, R., Selvalakshmi, V., Jyothi, P., & Velmurugan, P. R. (2026). Empowering patients through knowledge: Educational strategies in rehabilitation. In Holistic approaches to health recovery (pp. 263–290). IGI Global.
[44] Vettriselvan, R. (2025). Harnessing innovation and digital marketing in the era of industry 5.0: Resilient healthcare SMEs. In The future of small business in industry 5.0 (pp. 163–186). IGI Global.
[45] Vettriselvan, R., Velmurugan, P. R., Varshney, K. R., EP, J., & Deepika, R. (2025). Health impacts of smartphone and internet addictions across age groups: Physical and mental health across generations. In Impacts of digital technologies across generations (pp. 187–210). IGI Global.
[46] Vijayalakshmi, M., Subramani, A. K., Vettriselvan, R., Velmurugan, P. R., & Hasine, J. (2025). Strategic collaborations in medical innovation and AI-driven globalization: Advancing healthcare startups. In Navigating strategic partnerships for sustainable startup growth (pp. 85–110). IGI Global.
[47] Vinodh, N., & Subramani, A. K. (2026). Augmented and virtual reality for training and operations in motion-control environments. In Intelligent motion control for human-centered systems (pp. 153–178). IGI Global.
[48] Vinodh, N., Subramani, A. K., & Vettriselvan, R. (2026). Transforming the future of management and medical education: AI-driven innovations in curriculum design. In AI education strategies for future-proofing curriculum design (pp. 459–476). IGI Global.
[49] Yatish, Khatoon, N., & Kumar, A. (2026). Advancing preventive strategies for chronic disease management: Clinical, behavioral, and population-level perspectives. International Journal of Novel Trends and Innovation, 4(2).
[50] Zahoor, H., Mustafa, N., Ashifa, K. M., Safaei, M., & El Gamil, R. (2025). Unlocking resilience: Emotional intelligence and self-leadership shape stress perception among health students. International Journal of Innovation and Learning, 38(4), 395–419.