Faculty, Staff and Student Publications
Language
English
Publication Date
5-1-2026
Journal
Kidney Medicine
DOI
10.1016/j.xkme.2026.101326
PMID
42004656
PMCID
PMC13088993
PubMedCentral® Posted Date
3-12-2026
PubMedCentral® Full Text Version
Post-print
Abstract
Acute kidney injury (AKI) is a well-recognized complication of chimeric antigen receptor (CAR) T-cell therapy, typically attributed to cytokine release syndrome and acute tubular injury. However, glomerular disease post CAR-T cell is rare. We report a case of minimal change disease presenting with AKI and nephrotic-range proteinuria 3 weeks after B-cell maturation antigen-directed CAR-T cell therapy, ciltacabtagene autoleucel, in a patient with relapsed refractory multiple myeloma. The kidney biopsy revealed diffuse podocyte foot process effacement and a predominance of CD4+ T cells with potential on-target, off-tumor effect of B-cell maturation antigen-directed CAR-T cell therapy, leading to podocyte injury. The patient received one dose of rituximab along with a short course of corticosteroid and had complete kidney recovery by week 4 of therapy. This report emphasizes the need for further investigation into the mechanism of kidney toxicity following CAR-T cell therapy, and potential benefits and risks of immunosuppressive therapy in this context.
Keywords
CAR-T cells, multiple myeloma, glomerulonephritis, minimal change disease
Published Open-Access
yes
Recommended Citation
Shivaraj, Kiran; Mamlouk, Omar; Tchakarov, Amanda; et al., "Minimal Change Disease Following B-Cell Maturation Antigen-Directed Chimeric Antigen Receptor T-Cell Therapy" (2026). Faculty, Staff and Student Publications. 4085.
https://digitalcommons.library.tmc.edu/uthmed_docs/4085