Fig. 3.

Response of extramedullary lesions. (A) Patient RJ02 presented with plasmacytoma on his forehead at half a year after the onset of the disease. The tumor enlarged gradually and lasted for nearly 3 y although he had been treated with three lines of anti-MM drugs. The cranial MRI and mass puncture cytological examination confirmed myeloma cells in the tumor. Four months after CAR T infusion, the plasmacytoma was obviously reduced, and neither occupying lesion nor plasma cells were observed in the original site. (B) Patient RJ03 had multiple extramedullary infiltration lesions, including skin, lower jaw, and liver, all of which were examined by aspiration or pathological section. At day 19 post CAR T infusion, the masses on the skin disappeared. At day 30, the skull MRI showed that the tumor in the lower jaw was relieved. The occupying lesion in the liver disappeared at 6 mo after CAR T cell therapy. Red dashed circles and yellow arrows indicate the tumor lesions. (C) Flow cytometry analysis shows the intensity of anti-BCMA CAR antibody (ADA) in seven relapse/PD patients’ sera, which were collected at the two time points (at response and at relapse or progression) for each case. ADA positivity was defined as a positive ratio of more than 5%.