Safety and Tolerability of CAR T-Cell Therapy in Patients With End-Stage Kidney Disease on Hemodialysis: A Case Series

Clinical Practice Points•CAR T-cell therapy with idecabtagene vicleucel and ciltacabtagene autoleucel is feasible in patients with R/R MM requiring HD, with a manageable side effect profile using standard-dose cyclophosphamide and dose-reduced fludarabine.•Incidence of grade 3 or higher CRS and ICANS do not appear to be elevated in dialysis-dependent patients undergoing CAR T-cell therapy.•Grade 1 or 2 CRS and ICANS remain manageable in this patient population with standard supportive care.•Early and proactive use of granulocyte colony-stimulating factor (G-CSF) following CAR T-cell infusion may prevent the incidence and severity of neutropenia in ESKD patients on HD.