Equecabtagene autoleucel as sequential therapy in a multiple myeloma patient with renal failure: a case report

This report describes a case of a 50-year-old male with multiple myeloma (IgD-λ subtype) complicated by severe renal insufficiency. The patient completed 4 cycles of induction therapy followed by autologous hematopoietic stem cell transplantation. During maintenance therapy, intolerance developed due to recurrent infections, prompting treatment with equecabtagene autoleucel (CAR-T cell therapy). During treatment, mild cytokine release syndrome occurred with hematologic toxicities including grade 3 thrombocytopenia, but without severe neurological complications. At day 28 post-CAR-T infusion, the patient achieved complete remission with negative minimal residual disease. At 21 months of follow-up, the patient maintained complete remission without requiring additional maintenance therapy. The case suggests that renal failure is not an absolute contraindication for CAR-T cell therapy.