Resilience Redefined: How CAR T-Cell Therapy Gave One Young Mom a Fighting Chance Against Multiple Myeloma

Sponsored by Bristol Myers Squibb

At 40 years old, a devastating diagnosis brought Cecilia's life to a sudden halt. As a wife and mom of two young children, the Bay Area native's days were jam-packed with activities: making breakfast, school drop offs and pickups, and birthday parties. When she began experiencing constant exhaustion, she chalked it up as a normal part of parenthood. Everybody was always tired.

However, the fatigue was eventually accompanied by other symptoms that interfered with her daily life, even disrupting a family trip. She knew it was time to seek help. After an emergency room visit and a series of doctors' appointments, she was ultimately diagnosed with an incurable type of blood cancer called multiple myeloma.

Multiple myeloma originates in plasma cells in the bone marrow. While there have been treatment advances, people with this disease face recurring periods of remission (decrease in, or no evidence of, cancer) and relapse (the cancer returning).

While the gravity of the diagnosis sank in, Cecilia felt relieved that there was an explanation for how terrible she felt. In that moment, Cecilia decided that she would not let this diagnosis hold up her life. She wanted to make her family a priority, which meant finding the right treatment that would allow her to continue being present for her kids. "It was hard to wrap my head around the diagnosis," she said, "but we had a young family to take care of. I had groceries to buy, and we had vacations to take. My job was not done; I'm supposed to be here for a little while."

Treatments for multiple myeloma may include chemotherapy, immunotherapy or stem cell transplant. Most patients often experience an initial response to these treatments but eventually stop responding to therapy and relapse. "We just lived through years of different treatments, but nothing lasted," Cecilia recalled.

Still, Cecilia remained determined to fight her cancer. Eventually, her hematologist told her about a personalized procedure called "chimeric antigen receptor T cell therapy," commonly known as CAR T cell therapy. This treatment involves the use of the patient's own T cells, a type of white blood cell in the immune system, which are genetically "reprogrammed" to recognize and fight cancer cells in the blood. "I found it best to trust my medical team and visit the websites of the treatments they advised me on. That education was reassuring," Cecilia recalled. She felt strongly that there was no time to feel sorry for herself and wanted to do everything to be here for her children. She was fueled with hope at the prospect of a one-time infusion[1] that could give her more freedom from daily regimens while responding to treatment. Cecilia received the CAR T cell therapy ABECMA^® (idecabtagene vicleucel) on her son's birthday. ABECMA (idecabtagene vicleucel) is a prescription medicine for the treatment of multiple myeloma in patients who have received at least two kinds of treatment regimens that have not worked or have stopped working.

Please see full Prescribing Information, including Boxed WARNINGS and Medication Guide and Important Safety Information below.

"It was a bittersweet moment because I wanted to be home celebrating my son, showering him with love, but to him, the possibility of me getting better was the 'best birthday present,'" Cecilia smiled.

After Cecilia received her infusion, she experienced a low-grade fever, which was treated by her healthcare team, and she spent seven days in the hospital to be monitored for other serious side effects. Within a month after her treatment, Cecilia's doctor delivered great news: her disease was in remission.

[1] Treatment process includes blood collection, CAR T cell creation, administration, and side effect monitoring

About ABECMA

ABECMA is a one-time infusion, but the entire ABECMA treatment process can take two to three months from start to finish. After a blood draw that separates out the T cells from the blood, tiny hooks, called chimeric antigen receptors (CAR), are added to their surfaces, becoming CAR T cells which target the cancer cells and some normal cells in the blood. Millions of these CAR T cells are then reproduced to create the patient's recommended dose of ABECMA.

Prior to receiving ABECMA, patients are given three days of chemotherapy to prepare the body for the infusion. After receiving ABECMA, the care team closely monitors for and manages cytokine release syndrome (CRS; condition where a large amount of proteins called cytokines are released into the blood), neurologic toxicities (NTs), and common side effects, including fatigue, fever, chills or shivering, severe nausea or diarrhea, decreased appetite, headache, dizziness or lightheadedness, confusion, trouble speaking or slurred speech, coughing, trouble breathing, and fast or irregular heartbeat.

Life After Treatment

Patients living with multiple myeloma face lifelong challenges that can impact their personal, professional and social lives, taking a physical and emotional toll on them. Having treatment options like ABECMA available can potentially help patients manage their disease and get back to daily activities while responding to therapy.

Cecilia recalled feeling a weight off her shoulders once coming home after treatment. "Just talking with the kids felt euphoric," she said. She was delighted and grateful for the opportunity to create a new daily routine for herself and her family after going into remission.

More About ABECMA

Cecilia received ABECMA after four or more lines of therapy did not work for her. However, ABECMA is now available in earlier lines of treatment, based on the most recent trial evaluating 386 patients with relapsed or refractory multiple myeloma (RRMM) who received at least two prior medicines and were a median age of 63 years old. The majority (71%, 181/254) of patients treated with ABECMA responded to treatment, as compared to those who received standard treatment (43%, 56/132). Those who received ABECMA lived without their multiple myeloma coming back or progressing for 13.8 months, three times longer compared to 4.4 months for those who received standard treatment. Across two ABECMA clinical trials (n=349), 82% of people had mild or moderate CRS, 7% had severe or life-threatening CRS, including 3 people who had CRS leading to death; 34.9% had mild or moderate neurologic side effects, and 4.9% had severe or life-threatening neurologic side effects, including 1 person who had a neurologic side effect leading to death. Overall, the US Food and Drug Administration (FDA) has determined the benefits of ABECMA outweigh the risks.

These trial results demonstrate how ABECMA can help patients in earlier lines of therapy fight against their multiple myeloma.

Looking Ahead to the Future

Now, while she is responding to ABECMA, Cecilia has been able to jump back into some of the activities she enjoyed, such as walking every day with her two dogs and being around family, planning vacations and spending time with her children.

"After ABECMA, our life feels like freedom — the freedom to enjoy life with our kids, looking forward to moments in the future. It's just a world I thought I'd never get to live in," Cecilia said.

Visit ABECMA.com to hear from other patients who have received ABECMA and to learn more about if this CAR T cell therapy option could be the next step in your multiple myeloma journey.

Cecilia was compensated by Bristol Myers Squibb for sharing her story. This is an individual patient's experience. Talk to your doctor to determine if ABECMA is right for you. Please see Important Safety Information below, including potential side effects.

Important Safety Information

What is the most important information I should know about ABECMA?

ABECMA may cause side effects that are severe or life-threatening and can lead to death. Call your healthcare provider or get emergency help right away if you get any of the following:

• difficulty breathing

• fever (100.4°F/38°C or higher)

• chills/shivering

• confusion

• dizziness or lightheadedness

• shaking or twitching (tremor)

• fast or irregular heartbeat

• severe fatigue

• severe nausea, vomiting, diarrhea

It is important that you tell your healthcare providers that you have received ABECMA and to show them your ABECMA Patient Wallet Card. Your healthcare provider may give you other medicines to treat your side effects.

How will I receive ABECMA?

• ABECMA is made from your own white blood cells, so your blood will be collected by a process called "leukapheresis".

• Your blood cells will be sent to a manufacturing center to make your ABECMA. Based on clinical trial experience, it takes about 4 weeks from the time your cells are received at the manufacturing site and are available to be shipped back to your healthcare provider, but the time may vary.

• Before you get ABECMA, your healthcare provider will give you chemotherapy for 3 days to prepare your body.

• When your ABECMA is ready, your healthcare provider will give ABECMA to you through a catheter (tube) placed into your vein (intravenous infusion). Your dose of ABECMA may be given in one or more infusion bags. The infusion usually takes up to 30 minutes for each infusion bag.

• You will be monitored daily for at least 7 days after the infusion.

• You should plan to stay close to a healthcare facility for at least 2 weeks after getting ABECMA. Your healthcare provider will check to see that your treatment is working and help you with any side effects that may occur.

What should I avoid after receiving ABECMA?

• Avoid driving for at least 2 weeks after you get ABECMA.

• Do not donate blood, organs, tissues, or cells for transplantation.

What are the possible or reasonably likely side effects of ABECMA?

The most common side effects of ABECMA are:

• fatigue

• fever (100.4°F/38°C or higher)

• chills/shivering

• severe nausea or diarrhea

• decreased appetite

• headache

• dizziness/lightheadedness

• confusion

• difficulty speaking or slurred speech

• cough

• difficulty breathing

• fast or irregular heartbeat

In a study comparing ABECMA to standard regimen, a higher proportion of patients experienced death within the first 9 months from randomization in the ABECMA arm compared to the standard regimens arm. This higher rate of early death was mainly observed before receiving ABECMA with the main reason being progression of multiple myeloma. There was also an increase in the rate of death from adverse events after ABECMA.

ABECMA can cause a very common side effect called cytokine release syndrome, or CRS, which can be severe or fatal. Symptoms of CRS include fever, difficulty breathing, dizziness or light-headedness, nausea, headache, fast heartbeat, low blood pressure, or fatigue. Tell your healthcare provider right away if you develop fever or any of these other symptoms after receiving ABECMA.

ABECMA can increase the risk of life-threatening infections that may lead to death. Tell your healthcare provider right away if you develop fever, chills, or any signs or symptoms of an infection.

ABECMA can lower one or more types of your blood cells (red blood cells, white blood cells, or platelets), which may make you feel weak or tired or increase your risk of severe infection or bleeding. After treatment, your healthcare provider will test your blood to check for this. Tell your healthcare provider right away if you get a fever, are feeling tired, or have bruising or bleeding.

ABECMA may increase your risk of getting cancers including certain types of blood cancers. Your healthcare provider should monitor you for this.

Having ABECMA in your blood may cause a false-positive human immunodeficiency virus (HIV) test result by some commercial tests.

This is a summary of the most important safety information about ABECMA. These are not all the possible side effects of ABECMA. Call your doctor for medical advice about side effects. For more information, go to www.ABECMA.com or call 1-­888-­805-­4555. You may report side effects to the FDA. Visit: http://www.fda.gov/medwatch, or call 1­-800­-FDA­-1088.

Please see full Prescribing Information, including Boxed WARNINGS and Medication Guide.

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