ABECMA (idecabtagene vicleucel) is a B-cell maturation antigen (BCMA)-directed genetically modified autologous T cell immunotherapy indicated for the treatment of adult patients with relapsed or refractory multiple myeloma after two or more prior lines of therapy, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody.

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Across registrational studies (N=349),1*

Cytokine Release Syndrome (CRS) Predictability With ABECMA®†

Early onset with rapid resolution

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CRS, including fatal or life-threatening reactions, occurred following treatment with ABECMA.

Pooled registrational studies included KarMMa-3 and KarMMa (5L+).

Lee criteria for grading CRS (Lee et al, 2014).

Manifestations of CRS

Most common manifestations of CRS (N=349)

Pyrexia 87%
Hypotension 30%
Tachycardia 26%
Chills 19%
Hypoxia 16%


Grade 3 or higher events that may be associated with CRS include hypotension, hypoxia, hyperbilirubinemia, hypofibrinogenemia, ARDS, atrial fibrillation, hepatocellular injury, metabolic acidosis, pulmonary edema, coagulopathy, renal failure, multiple organ dysfunction syndrome, and HLH/MAS.

CRS monitoring and management

  • Counsel patients to seek immediate medical attention should signs or symptoms of CRS occur at any time
  • Instruct patients to remain within proximity of the certified healthcare facility for at least 4 weeks following infusion
  • Monitor patients for signs and symptoms of CRS
    • At least daily for 7 days at the certified healthcare facility following ABECMA infusion
    • For at least 4 weeks after ABECMA infusion
  • Treat at the first sign of CRS with supportive care, tocilizumab, and/or corticosteroids as needed based on the grading and management guidelines
    • If CRS is suspected, manage according to the recommendations in the full Prescribing Information
    • If concurrent CRS is suspected during a neurologic toxicity event, manage CRS according to the recommendations in the full Prescribing Information
  • Ensure that a minimum of 2 doses of tocilizumab per patient are available prior to infusion of ABECMA

CRS treatment

  • Treat at the first sign of CRS with supportive care, tocilizumab, and/or corticosteroids as indicated
  • Identify CRS based on clinical presentation. Evaluate for and treat other causes of fever, hypoxia, and hypotension
  • CRS has been reported to be associated with findings of HLH/MAS, and the physiology of the syndromes may overlap
    • In patients with progressive symptoms of CRS or refractory CRS despite treatment, evaluate for evidence of HLH/MAS
  • 65% (226/349) of patients received tocilizumab
    • 39% (135/349) received a single dose
    • 26% (91/349) received more than 1 dose
  • Overall, 24% (82/349) of patients received at least 1 dose of corticosteroids for treatment of CRS
    • Almost all patients who received corticosteroids for CRS also received tocilizumab

ARDS=acute respiratory distress syndrome; HLH/MAS=hemophagocytic lymphohistiocytosis/macrophage activation syndrome; NT=neurologic toxicity.

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