Relapsed/Refractory Multiple Myeloma: Setting Expectations After CAR T-Cell Therapy

Dr. Joshua Richter and Dr. Marco Davila discuss how to counsel patients with relapsed/refractory multiple myeloma (RRMM) about recovery and long-term follow-up after CAR T-cell therapy. Dr. Davila explains that although CAR T-cell therapy is often described as a "one-and-done" treatment, patients should understand that ongoing monitoring remains an important part of post-treatment care. He reviews the need for routine follow-up visits, laboratory assessments, surveillance for immune suppression, and evaluation for delayed toxicities, while noting that some patients may require interventions such as intravenous immunoglobulin replacement, antimicrobial support, or management of neurologic complications. At the same time, he emphasizes that most patients primarily require observation rather than intensive treatment after recovery. The discussion also highlights how increasing clinical experience with CAR T-cell therapy has improved the recognition and management of treatment-related toxicities, with the expectation that continued advances will further reduce long-term complications and lessen the burden of follow-up care for patients with RRMM.