Serum ferritin as a prognostic biomarker in CAR-T therapy for multiple myeloma: A meta-analysis
Serum ferritin, a marker of systemic inflammation and iron metabolism, has been implicated in the outcomes of patients with relapsed/refractory multiple myeloma (R/R MM). However, its prognostic significance in R/R MM patients undergoing chimeric antigen receptor-modified T-cell (CAR-T) therapy rem...
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Association of Basic Medical Sciences of Federation of Bosnia and Herzegovina
2025-03-01
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| Series: | Biomolecules & Biomedicine |
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| Online Access: | http://www.bjbms.org/ojs/index.php/bjbms/article/view/12129 |
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| author | Jing Cheng Yuan Song |
| author_facet | Jing Cheng Yuan Song |
| author_sort | Jing Cheng |
| collection | DOAJ |
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Serum ferritin, a marker of systemic inflammation and iron metabolism, has been implicated in the outcomes of patients with relapsed/refractory multiple myeloma (R/R MM). However, its prognostic significance in R/R MM patients undergoing chimeric antigen receptor-modified T-cell (CAR-T) therapy remains unclear. This meta-analysis aimed to evaluate the association between pre-infusion serum ferritin levels and survival outcomes in R/R MM patients treated with CAR-T therapy. We systematically searched PubMed, Embase, and Web of Science for relevant studies. Studies reporting progression-free survival (PFS) and/or overall survival (OS) based on serum ferritin levels were included. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Eight retrospective cohort studies, encompassing 1,077 patients, met the inclusion criteria. High pre-infusion serum ferritin levels were significantly associated with worse PFS (HR: 2.15, 95% CI: 1.74–2.66, p < 0.001) and OS (HR: 2.86, 95% CI: 2.20–3.72, p < 0.001), with mild heterogeneity (I² = 9% for PFS and 0% for OS). Sensitivity analyses, conducted by excluding one study at a time, confirmed the robustness of these findings. Subgroup analyses showed consistent results across different CAR-T product sources (commercial vs. academic), ferritin cutoffs, and follow-up durations (p for subgroup differences all > 0.05). In conclusion, elevated serum ferritin levels before CAR-T infusion predict poorer survival outcomes in R/R MM patients. These findings highlight the potential prognostic value of ferritin and its role in optimizing patient selection and management strategies in CAR-T therapy.
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| format | Article |
| id | doaj-art-2c34ac8789dd4bcd8e19172d6bcdbc0f |
| institution | OA Journals |
| issn | 2831-0896 2831-090X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Association of Basic Medical Sciences of Federation of Bosnia and Herzegovina |
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| series | Biomolecules & Biomedicine |
| spelling | doaj-art-2c34ac8789dd4bcd8e19172d6bcdbc0f2025-08-20T01:53:16ZengAssociation of Basic Medical Sciences of Federation of Bosnia and HerzegovinaBiomolecules & Biomedicine2831-08962831-090X2025-03-0110.17305/bb.2025.12129Serum ferritin as a prognostic biomarker in CAR-T therapy for multiple myeloma: A meta-analysisJing Cheng0Yuan Song1Department of Hematology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Donghu District, Nanchang City, Jiangxi Province, ChinaDepartment of Hematology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Donghu District, Nanchang City, Jiangxi Province, China Serum ferritin, a marker of systemic inflammation and iron metabolism, has been implicated in the outcomes of patients with relapsed/refractory multiple myeloma (R/R MM). However, its prognostic significance in R/R MM patients undergoing chimeric antigen receptor-modified T-cell (CAR-T) therapy remains unclear. This meta-analysis aimed to evaluate the association between pre-infusion serum ferritin levels and survival outcomes in R/R MM patients treated with CAR-T therapy. We systematically searched PubMed, Embase, and Web of Science for relevant studies. Studies reporting progression-free survival (PFS) and/or overall survival (OS) based on serum ferritin levels were included. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Eight retrospective cohort studies, encompassing 1,077 patients, met the inclusion criteria. High pre-infusion serum ferritin levels were significantly associated with worse PFS (HR: 2.15, 95% CI: 1.74–2.66, p < 0.001) and OS (HR: 2.86, 95% CI: 2.20–3.72, p < 0.001), with mild heterogeneity (I² = 9% for PFS and 0% for OS). Sensitivity analyses, conducted by excluding one study at a time, confirmed the robustness of these findings. Subgroup analyses showed consistent results across different CAR-T product sources (commercial vs. academic), ferritin cutoffs, and follow-up durations (p for subgroup differences all > 0.05). In conclusion, elevated serum ferritin levels before CAR-T infusion predict poorer survival outcomes in R/R MM patients. These findings highlight the potential prognostic value of ferritin and its role in optimizing patient selection and management strategies in CAR-T therapy. http://www.bjbms.org/ojs/index.php/bjbms/article/view/12129Multiple myelomachimeric antigen receptor-modified T cellsCAR-Tferritinsurvivalprogression |
| spellingShingle | Jing Cheng Yuan Song Serum ferritin as a prognostic biomarker in CAR-T therapy for multiple myeloma: A meta-analysis Biomolecules & Biomedicine Multiple myeloma chimeric antigen receptor-modified T cells CAR-T ferritin survival progression |
| title | Serum ferritin as a prognostic biomarker in CAR-T therapy for multiple myeloma: A meta-analysis |
| title_full | Serum ferritin as a prognostic biomarker in CAR-T therapy for multiple myeloma: A meta-analysis |
| title_fullStr | Serum ferritin as a prognostic biomarker in CAR-T therapy for multiple myeloma: A meta-analysis |
| title_full_unstemmed | Serum ferritin as a prognostic biomarker in CAR-T therapy for multiple myeloma: A meta-analysis |
| title_short | Serum ferritin as a prognostic biomarker in CAR-T therapy for multiple myeloma: A meta-analysis |
| title_sort | serum ferritin as a prognostic biomarker in car t therapy for multiple myeloma a meta analysis |
| topic | Multiple myeloma chimeric antigen receptor-modified T cells CAR-T ferritin survival progression |
| url | http://www.bjbms.org/ojs/index.php/bjbms/article/view/12129 |
| work_keys_str_mv | AT jingcheng serumferritinasaprognosticbiomarkerincarttherapyformultiplemyelomaametaanalysis AT yuansong serumferritinasaprognosticbiomarkerincarttherapyformultiplemyelomaametaanalysis |