An in-depth analysis of tissue biopsies from patients with multiple myeloma and CART-associated immune-related adverse events (CirAE) after treatment with commercial BCMA-CART shows that CD4+ CARTs mediate off tumor toxicities and that high CD4/CD8 ratio at apheresis, robust early CART expansion, ICANS, and cilta-cel treatment are independently associated with the development of CirAEs.
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