Yuri, a 39-year-old from Russia, began experiencing bone pain and fatigue in 2023, later accompanied by nosebleeds and gum bleeding. After a comprehensive examination, he was diagnosed with IgA-κ type multiple myeloma, classified as R-ISS Stage III, indicating a high-risk profile. He underwent multiple rounds of chemotherapy and an autologous hematopoietic stem cell transplant in his home country. Although he initially achieved partial remission, the disease relapsed. The tumor cell burden increased, accompanied by complex chromosomal abnormalities and extramedullary infiltration, making the situation extremely challenging. Local doctors recommended he pursue more advanced therapies. With hope, Yuri traveled from Russia to Beijing Boren Hospital to seek further treatment under Professor Zhang Yajing's team.

Upon admission, Yuri's condition was highly complex. Tests revealed not only severe bone destruction but also extramedullary plasmacytomas in multiple organs including the liver, stomach, spleen, pancreas, and pelvic cavity, indicating a very high tumor burden. His treatment posed several critical challenges:

1. Heavy Tumor Burden and Rapid Progression

Whole-body nuclear imaging revealed widespread infiltration with clear systemic symptoms.

2. High Treatment Risk

Due to multiple prior treatments, Yuri's immune system was severely compromised, and he suffered significant bone marrow suppression, increasing his risk of infections and bleeding.

3. Severe CAR-T Related Complications

After receiving cutting-edge BCMA CAR-T and GPRC5D CAR-T cell therapies, Yuri experienced severe adverse reactions such as high fever, low blood pressure, arrhythmias, and even developed Hemophagocytic Lymphohistiocytosis (HLH)—a potentially life-threatening complication. The entire treatment process was fraught with danger and uncertainty.

Led by Professor Zhang Yajing, the team implemented a personalized and multidisciplinary approach:

• Customized Treatment Design: After ruling out contraindications, a dual-target CAR-T therapy was administered following intensive chemotherapy to maximize tumor cell clearance.
• Multifaceted Interventions to Manage Complications: To address cytokine release syndrome (CRS), the team escalated treatment—from anti-infection measures to the use of tocilizumab, dexamethasone, and vasopressor support—eventually gaining control over the symptoms.
• Cross-Disciplinary Collaboration: Experts from cardiology, infectious diseases, and critical care worked closely to monitor and manage complications like arrhythmia, hypotension, and hypoxemia.
• Dynamic Monitoring and Emergency Interventions: During the HLH outbreak, the team promptly initiated plasma exchange, alongside supportive transfusions, hemostatic therapies, and immunosuppressants. These interventions gradually calmed the inflammatory storm and maintained stable vital signs.

Each crisis was handled with precision and care. Thanks to the team's extensive experience in managing critically ill international patients, Yuri eventually made it through the most dangerous phase.

After 40 days of hospitalization, Yuri's vital signs stabilized, and his pain significantly subsided. Lab results confirmed that the inflammatory storm had been controlled, CAR-T cells had expanded well, and tumor markers had dropped significantly—meeting the discharge criteria.

Professor Zhang and her team developed a scientific follow-up and maintenance treatment plan to help consolidate Yuri's treatment outcomes and support his long-term recovery.

Looking back on his experience, Yuri and his family expressed heartfelt gratitude: “Here, we found not only advanced medical technology but also a team that was always there to protect me.”