Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access
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Case Report

Volume 14, Number 3, June 2025, pages 146-151

Ruxolitinib Is an Effective Therapy for Ciltacabtagene Autoleucel-Associated Parkinsonism in Multiple Myeloma

Figures

Figure 1.
Figure 1. Structural imaging with MRI T1WI of the brain for case 1. (a) Increased T1 signal of the basal ganglia (arrowheads) at diagnosis, not seen before cilta-cell infusion. (b) Post-treatment scan with resolution of prior T1 hyperintense signal of basal ganglia. MRI: magnetic resonance imaging; T1WI: T1-weighted image.
Figure 2.
Figure 2. Functional imaging for case 1 (a-c) and case 2 (d, e). (a) PET AC and (b) voxel-based analysis of brain PET normalized to standard dataset using MIMneuro software show significant decreased metabolism in bilateral caudate and frontal lobe/gyri. (c) DAT SPECT scan demonstrates symmetric normal uptake of basal ganglia. (d) PET AC and (e) normalized voxel-based analysis of PET brain demonstrate significant decreased metabolism in bilateral frontal lobe/gyri. AC: attenuation correction; DAT: dopamine activated transporter; PET: positron emission tomography; SPECT: single photon emission computed tomography.

Table

Table 1. Inflammatory Markers Before and After Ruxolitinib
 
Inflammatory markersCase 1Case 2
sIL-2R: soluble interleukin-2 receptor.
At onset of parkinsonism before ruxolitinib
  Absolute lymphocyte count (1.1 - 3.3 × 109/L)1.4 × 1097.6 × 109
  Ferritin (16 - 150 ng/mL)> 30,0009,258
  Fibrinogen (200 - 450 mg/dL)9099
  sIL-2R (223 - 770 U/mL)8,1802,826
After resolution of parkinsonism with ruxolitinib
  Absolute lymphocyte count (1.1 - 3.3 × 109 /L)1.1 × 1090.7 × 109
  Ferritin (16 - 150 ng/mL)782798
  Fibrinogen (200 - 450 mg/dL)360338
  sIL-2R (223 - 770 U/mL)245296