Pub Date : 2026-02-01DOI: 10.1016/j.clml.2025.10.002
Muhammad Salman Faisal , Aqeeb Ur Rehman , Aleenah Mohsin , Husnain Mushtaq , Wania Ur Rehman , Mashhood Ur Rehman , Haseeba Javed , Fizza Mohsin , Muhammad Talha Shaukat , Bibi Maryam , Mohammad Ammar al Osama , Salman Fazal
Background
Tyrosine kinase inhibitors (TKIs) are essential therapies for chronic myeloid leukemia (CML), yet their safety during pregnancy remains poorly characterized. We aimed to address this gap by providing pharmacovigilance data using the FDA Adverse Event Reporting System (FAERS).
Methods
We conducted a comprehensive pharmacovigilance analysis of pregnancy-related adverse events (AEs) reported to FAERS between January 2001 and December 2024. Reports involving female patients exposed to imatinib, dasatinib, nilotinib, ponatinib, bosutinib, or asciminib were extracted. Pregnancy-related AEs were categorized into maternal and fetal outcomes and presented descriptively. Disproportionality analyses were also performed for 2022–2024 to determine only the more relevant AEs in contemporary clinical practice. Reporting odds ratios (RORs) with 95% confidence intervals (CI) were used to quantify associations.
Results
A total of 651 relevant pregnancy-related AEs were identified between 2001 and 2024, with imatinib accounting for the majority (n = 450), followed by nilotinib (n = 118), dasatinib (n = 64), ponatinib (n = 13), bosutinib (n = 4), and asciminib (n = 2). The most frequently reported maternal AEs were abortion (40.6%) and polyhydramnios (4.3%), while the most frequent perinatal complications included premature delivery (33.6%) and low birth weight (4.4%). In the disproportionality analysis (2022–2024), imatinib was significantly associated with pregnancy-related AEs (ROR 3.47; 95% CI: 1.49-8.05).
Conclusion
This pharmacovigilance analysis suggests a signal of pregnancy-related adverse events with imatinib, while evidence for other TKIs remains limited. Given the paucity of data, results should be interpreted with caution. Larger studies are needed to confirm these findings.
{"title":"Pregnancy-Related Adverse Events with Tyrosine Kinase Inhibitor Use in Chronic Myeloid Leukemia: A FAERS Pharmacovigilance Analysis (2001-2024)","authors":"Muhammad Salman Faisal , Aqeeb Ur Rehman , Aleenah Mohsin , Husnain Mushtaq , Wania Ur Rehman , Mashhood Ur Rehman , Haseeba Javed , Fizza Mohsin , Muhammad Talha Shaukat , Bibi Maryam , Mohammad Ammar al Osama , Salman Fazal","doi":"10.1016/j.clml.2025.10.002","DOIUrl":"10.1016/j.clml.2025.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Tyrosine kinase inhibitors (TKIs) are essential therapies for chronic myeloid leukemia (CML), yet their safety during pregnancy remains poorly characterized. We aimed to address this gap by providing pharmacovigilance data using the FDA Adverse Event Reporting System (FAERS).</div></div><div><h3>Methods</h3><div>We conducted a comprehensive pharmacovigilance analysis of pregnancy-related adverse events (AEs) reported to FAERS between January 2001 and December 2024. Reports involving female patients exposed to imatinib, dasatinib, nilotinib, ponatinib, bosutinib, or asciminib were extracted. Pregnancy-related AEs were categorized into maternal and fetal outcomes and presented descriptively. Disproportionality analyses were also performed for 2022–2024 to determine only the more relevant AEs in contemporary clinical practice. Reporting odds ratios (RORs) with 95% confidence intervals (CI) were used to quantify associations.</div></div><div><h3>Results</h3><div>A total of 651 relevant pregnancy-related AEs were identified between 2001 and 2024, with imatinib accounting for the majority (n = 450), followed by nilotinib (n = 118), dasatinib (n = 64), ponatinib (n = 13), bosutinib (n = 4), and asciminib (n = 2). The most frequently reported maternal AEs were abortion (40.6%) and polyhydramnios (4.3%), while the most frequent perinatal complications included premature delivery (33.6%) and low birth weight (4.4%). In the disproportionality analysis (2022–2024), imatinib was significantly associated with pregnancy-related AEs (ROR 3.47; 95% CI: 1.49-8.05).</div></div><div><h3>Conclusion</h3><div>This pharmacovigilance analysis suggests a signal of pregnancy-related adverse events with imatinib, while evidence for other TKIs remains limited. Given the paucity of data, results should be interpreted with caution. Larger studies are needed to confirm these findings.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 2","pages":"Pages e229-e232"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145430429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.clml.2025.10.003
Matthew J. Rees , Timothy T. Xu , Suheil Albert Atallah-Yunes , Kenneth J C Lim , Sikander Ailawadhi , Ricardo Parrondo , Rafael Fonseca , Peter Leif Bergsagel , Suzanne Hayman , Angela Dispenzieri , Francis Buadi , David Dingli , Rahma Warsame , Prashant Kapoor , Jithma P Abeykoon , Morie A. Gertz , Eli Muchtar , Taxiarchis Kourelis , Wilson Gonsalves , S. Vincent Rajkumar , Shaji Kumar
Introduction
Uptake of BCMA-directed antibody drug conjugates (ADCs) in multiple myeloma has been hindered by ocular side-effects. Belantamab mafodotin (BelMaf) and MEDI2228 are BCMA-directed monoclonal-antibodies conjugated to the microtubule inhibitor, monomethyl auristatin F and the alkylator, pyrrolobenzodiazepine, respectively. Differences in ADC payload, antibody specificity and linker stability influence ocular toxicity.
Aim/Methods
We investigated the tolerability and ocular toxicity profiles of BCMA-directed ADC therapy. Retrospective study of 111 patients treated with BCMA-directed ADCs between 2019 and 2022.
Results
Eighty-seven percent of patients were triple-class refractory, 50% penta-class refractory, 14% had prior BCMA-directed therapy and 24% extraosseous disease. Treatments included BelMaf monotherapy (n = 56), BelMaf combination therapy (n = 12) and MEDI2228 monotherapy (n = 43). The overall response rate was 30% for BelMaf and 44% for MEDI2228. Photophobia was more common with MEDI2228 (any-grade: 12% vs. 49%, P < .001), whereas keratopathy was more common with BelMaf (any-grade: 59% vs. 9%, P = .002). Four MEDI2228 recipients developed keratopathy, all grade 1 and associated with dry eyes and/or photophobia. Dose delay for ocular toxicity was comparable for BelMaf and MEDI2228 (28% vs. 19%, P = 0.2), as was the rate of dose reduction (18% vs. 12%, P = .4). The most common reasons for treatment discontinuation were progression/death (BelMaf = 71%, MEDI2228 = 44%) and ocular toxicity (BelMaf = 18%, MEDI2228 = 30%).
Conclusions
Treatment interruptions, dose reductions and drug discontinuation are common with BCMA-directed ADC therapy. Research to optimize the administration schedule of these agents is warranted. BelMaf and MEDI2228 produce distinct patterns of ocular side-effects, namely keratopathy and reduced visual-acuity with the former, and photophobia and dry eyes with the latter.
{"title":"Dose Delays and Treatment Interruptions Secondary to Ocular Toxicity From BCMA-Directed Antibody Drug Conjugate Therapy in Relapsed Multiple Myeloma","authors":"Matthew J. Rees , Timothy T. Xu , Suheil Albert Atallah-Yunes , Kenneth J C Lim , Sikander Ailawadhi , Ricardo Parrondo , Rafael Fonseca , Peter Leif Bergsagel , Suzanne Hayman , Angela Dispenzieri , Francis Buadi , David Dingli , Rahma Warsame , Prashant Kapoor , Jithma P Abeykoon , Morie A. Gertz , Eli Muchtar , Taxiarchis Kourelis , Wilson Gonsalves , S. Vincent Rajkumar , Shaji Kumar","doi":"10.1016/j.clml.2025.10.003","DOIUrl":"10.1016/j.clml.2025.10.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Uptake of BCMA-directed antibody drug conjugates (ADCs) in multiple myeloma has been hindered by ocular side-effects. Belantamab mafodotin (BelMaf) and MEDI2228 are BCMA-directed monoclonal-antibodies conjugated to the microtubule inhibitor, monomethyl auristatin F and the alkylator, pyrrolobenzodiazepine, respectively. Differences in ADC payload, antibody specificity and linker stability influence ocular toxicity.</div></div><div><h3>Aim/Methods</h3><div>We investigated the tolerability and ocular toxicity profiles of BCMA-directed ADC therapy. Retrospective study of 111 patients treated with BCMA-directed ADCs between 2019 and 2022.</div></div><div><h3>Results</h3><div>Eighty-seven percent of patients were triple-class refractory, 50% penta-class refractory, 14% had prior BCMA-directed therapy and 24% extraosseous disease. Treatments included BelMaf monotherapy (<em>n</em> = 56), BelMaf combination therapy (<em>n</em> = 12) and MEDI2228 monotherapy (<em>n</em> = 43). The overall response rate was 30% for BelMaf and 44% for MEDI2228. Photophobia was more common with MEDI2228 (any-grade: 12% vs. 49%, <em>P</em> < .001), whereas keratopathy was more common with BelMaf (any-grade: 59% vs. 9%, <em>P</em> = .002). Four MEDI2228 recipients developed keratopathy, all grade 1 and associated with dry eyes and/or photophobia. Dose delay for ocular toxicity was comparable for BelMaf and MEDI2228 (28% vs. 19%, <em>P</em> = 0.2), as was the rate of dose reduction (18% vs. 12%, <em>P</em> = .4). The most common reasons for treatment discontinuation were progression/death (BelMaf = 71%, MEDI2228 = 44%) and ocular toxicity (BelMaf = 18%, MEDI2228 = 30%).</div></div><div><h3>Conclusions</h3><div>Treatment interruptions, dose reductions and drug discontinuation are common with BCMA-directed ADC therapy. Research to optimize the administration schedule of these agents is warranted. BelMaf and MEDI2228 produce distinct patterns of ocular side-effects, namely keratopathy and reduced visual-acuity with the former, and photophobia and dry eyes with the latter.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 2","pages":"Pages e233-e240.e2"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145399548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.clml.2025.11.007
Borja Puertas , Elena Alejo , José J. Pérez-Morán , Fe Serra-Toral , Irene Padilla , Julio Dávila-Valls , Aránzazu García-Mateo , José María Alonso-Alonso , Roberto Hernández , Carlos Aguilar-Franco , Rosa López-López , Alfonso García-Coca , Alberto Cantalapiedra-Diez , Abelardo Bárez , Beatriz Rey-Búa , Lucía López-Corral , Juan Flores-Montero , M Belén Vidriales-Vicente , Norma C. Gutiérrez , Verónica González-Calle , Maria-Victoria Mateos
Background
The monoclonal gammopathy of uncertain significance (MGUS)-like model classifies multiple myeloma (MM) patients into 3 groups – MGUS-like, intermediate and MM-like––based on quantification of plasma cells (PCs) and clonal PCs in bone marrow, with distinct progression-free survival (PFS). We hypothesize that this model identifies patients with different characteristics that may influence the efficacy of autologous stem cell transplantation (ASCT).
Methods
A multicenter retrospective study was conducted including MM who underwent ASCT in the University Hospital of Salamanca between 2005 and 2023. The phenotypic profile was performed using the calculator available on the web site https://www.mgus-like.com/
Results
Four hundred and fifteen patients who underwent ASCT between 2005 and 2023 were included: 39 MGUS-like (9.4%), 187 intermediate (45.1%) and 189 (45.5%) MM-like. MGUS-like patients more likely had low ISS/R-ISS, less BM infiltration, less secretory disease, less CRAB (except for lytic lesions) and had more bone-related plasmacytomas. Most patients received ASCT in the first line, with no differences in induction regimens among groups. The MGUS-like group achieved stronger responses after ASCT, defined as complete response and minimal residual disease negative (CR MRD−ve), 70.3%, than the intermediate (47.0%) and MM-like groups (40.6%). Additionally, the MGUS-like profile was identified as an independent predictor of CR MRD−ve and PFS, decreasing the likelihood of progression or death by 40% to 60% to the other phenotypic profiles.
Conclusion
The MGUS-like profile is a baseline-evaluable feature that identifies a subset of patients with distinct clinical behavior and may predict greater benefit from high-dose melphalan, due to the high rate of CR MRD−ve resulting in longer survival.
背景：基于骨髓浆细胞（PCs）和克隆PCs的定量，单克隆gammopathy of uncertain significance (MGUS)-like模型将多发性骨髓瘤（MM）患者分为MGUS-like、intermediate和MM-like 3组，无进展生存期（PFS）差异明显。我们假设该模型可以识别具有不同特征的患者，这些特征可能会影响自体干细胞移植（ASCT）的疗效。方法：对2005年至2023年在萨拉曼卡大学医院行ASCT的MM进行多中心回顾性研究。结果：纳入2005年至2023年间接受ASCT的415例患者：39例mgus样（9.4%），187例中间（45.1%）和189例mm样（45.5%）。mgus样患者ISS/R-ISS较低，BM浸润较少，分泌性疾病较少，CRAB较少（溶性病变除外），骨相关浆细胞瘤较多。大多数患者在一线接受ASCT，组间诱导方案无差异。mgus样组在ASCT后获得了更强的应答，定义为完全缓解和最小残留病阴性（CR MRD-ve）， 70.3%，高于中间组（47.0%）和mm样组（40.6%）。此外，mgus样表型被确定为CR MRD-ve和PFS的独立预测因子，与其他表型相比，其进展或死亡的可能性降低了40%至60%。结论：mgs样特征是一个基线可评估的特征，可以识别出具有不同临床行为的患者亚群，并且可以预测高剂量美法兰的更大益处，因为高CR MRD-ve发生率导致更长的生存期。
{"title":"Clinic-Biological Features and Prognostic Significance of MGUS-Like Myeloma who underwent to Autologous Stem Cell Transplantation","authors":"Borja Puertas , Elena Alejo , José J. Pérez-Morán , Fe Serra-Toral , Irene Padilla , Julio Dávila-Valls , Aránzazu García-Mateo , José María Alonso-Alonso , Roberto Hernández , Carlos Aguilar-Franco , Rosa López-López , Alfonso García-Coca , Alberto Cantalapiedra-Diez , Abelardo Bárez , Beatriz Rey-Búa , Lucía López-Corral , Juan Flores-Montero , M Belén Vidriales-Vicente , Norma C. Gutiérrez , Verónica González-Calle , Maria-Victoria Mateos","doi":"10.1016/j.clml.2025.11.007","DOIUrl":"10.1016/j.clml.2025.11.007","url":null,"abstract":"<div><h3>Background</h3><div>The monoclonal gammopathy of uncertain significance (MGUS)-like model classifies multiple myeloma (MM) patients into 3 groups – MGUS-like, intermediate and MM-like––based on quantification of plasma cells (PCs) and clonal PCs in bone marrow, with distinct progression-free survival (PFS). We hypothesize that this model identifies patients with different characteristics that may influence the efficacy of autologous stem cell transplantation (ASCT).</div></div><div><h3>Methods</h3><div>A multicenter retrospective study was conducted including MM who underwent ASCT in the University Hospital of Salamanca between 2005 and 2023. The phenotypic profile was performed using the calculator available on the web site <span><span>https://www.mgus-like.com/</span><svg><path></path></svg></span></div></div><div><h3>Results</h3><div>Four hundred and fifteen patients who underwent ASCT between 2005 and 2023 were included: 39 MGUS-like (9.4%), 187 intermediate (45.1%) and 189 (45.5%) MM-like. MGUS-like patients more likely had low ISS/R-ISS, less BM infiltration, less secretory disease, less CRAB (except for lytic lesions) and had more bone-related plasmacytomas. Most patients received ASCT in the first line, with no differences in induction regimens among groups. The MGUS-like group achieved stronger responses after ASCT, defined as complete response and minimal residual disease negative (CR MRD−ve), 70.3%, than the intermediate (47.0%) and MM-like groups (40.6%). Additionally, the MGUS-like profile was identified as an independent predictor of CR MRD−ve and PFS, decreasing the likelihood of progression or death by 40% to 60% to the other phenotypic profiles.</div></div><div><h3>Conclusion</h3><div>The MGUS-like profile is a baseline-evaluable feature that identifies a subset of patients with distinct clinical behavior and may predict greater benefit from high-dose melphalan, due to the high rate of CR MRD−ve resulting in longer survival.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 2","pages":"Pages e213-e222.e3"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.clml.2025.09.008
Ajoy L. Dias , Mark R. Litzow
Immunotherapy has transformed the treatment of acute lymphoblastic leukemia (ALL) over the past 2 decades with excellent outcomes in both adults and children particularly in the relapsed/refractory (R/R) disease setting where in general the treatment outcomes are dismal. Several immune therapies including monoclonal antibodies, bispecific T cell engagers, antibody-drug conjugates, and chimeric antigen receptor T-cells have shown excellent outcomes and safety in this setting. Based on the observed high response rates and improved survival outcomes in patients with R/R ALL, immunotherapy is now being prospectively studied in the upfront setting with an aim to reduce treatment related toxicity and death with conventional chemotherapy. In this manuscript we discuss the various clinical trials that have shown excellent outcomes in the frontline setting and discuss how best to incorporate them in newly diagnosed, treatment naïve ALL patients either as monotherapy or in combination with cytotoxic agents.
{"title":"SOHO State of the Art Updates and Next Questions | Incorporating Immunotherapy into Upfront Acute Lymphoblastic Leukemia Therapy","authors":"Ajoy L. Dias , Mark R. Litzow","doi":"10.1016/j.clml.2025.09.008","DOIUrl":"10.1016/j.clml.2025.09.008","url":null,"abstract":"<div><div>Immunotherapy has transformed the treatment of acute lymphoblastic leukemia (ALL) over the past 2 decades with excellent outcomes in both adults and children particularly in the relapsed/refractory (R/R) disease setting where in general the treatment outcomes are dismal. Several immune therapies including monoclonal antibodies, bispecific T cell engagers, antibody-drug conjugates, and chimeric antigen receptor T-cells have shown excellent outcomes and safety in this setting. Based on the observed high response rates and improved survival outcomes in patients with R/R ALL, immunotherapy is now being prospectively studied in the upfront setting with an aim to reduce treatment related toxicity and death with conventional chemotherapy. In this manuscript we discuss the various clinical trials that have shown excellent outcomes in the frontline setting and discuss how best to incorporate them in newly diagnosed, treatment naïve ALL patients either as monotherapy or in combination with cytotoxic agents.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 2","pages":"Pages e141-e156"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The coexistence of solid tumors and multiple myeloma (MM) presents diagnostic and therapeutic challenges; however, data on clinical outcomes in this population remain limited. This study aimed to evaluate the clinical characteristics and survival outcomes of patients with newly diagnosed multiple myeloma (NDMM) who had synchronous or prior solid tumor malignancies.
Methods
A retrospective analysis was conducted on 41 NDMM patients with a documented history of solid tumor, classified as either concurrent (diagnosed within 6 months) or prior. Clinical characteristics, treatment patterns, and outcomes were evaluated. Patients were stratified according to the timing of solid tumor diagnosis.
Results
The median age was 66 years, with a male predominance (58.5%). Breast (24.4%), lung (17.1%), colon, and prostate cancers (9.8% each) were the most common solid tumors. Extramedullary disease was observed only in the synchronous group (100% vs. 0%). Autologous transplantation was performed significantly less frequently in the synchronous group (26.3% vs. 73.7%, P = 0.041). Lenalidomide maintenance therapy was underutilized in patients with synchronous malignancies, reflecting possible clinical hesitation. Myeloma-related mortality occurred in 17.1% of patients, with a median overall survival of 48 months (range: 16-80), and no significant survival difference between synchronous and patient with prior solid tumor history group.
Conclusion
The presence of synchronous solid tumors in NDMM patients is associated with a higher rate of extramedullary disease and may influence clinical decision-making, highlighting the need for multidisciplinary management and individualized treatment strategies. Furthermore, extramedullary involvement in MM should prompt evaluation for a potential coexisting solid malignancy.
实体瘤和多发性骨髓瘤（MM）的共存给诊断和治疗带来了挑战；然而，这一人群的临床结果数据仍然有限。本研究旨在评估伴有同步或既往实体肿瘤恶性肿瘤的新诊断多发性骨髓瘤（NDMM）患者的临床特征和生存结局。方法：回顾性分析41例有实体瘤病史的NDMM患者，分为并发（6个月内诊断）和既往。评估临床特征、治疗模式和结果。根据实体瘤诊断时间对患者进行分层。结果：中位年龄66岁，男性占58.5%。乳腺癌（24.4%）、肺癌（17.1%）、结肠癌和前列腺癌（各9.8%）是最常见的实体肿瘤。仅在同步组观察到髓外疾病（100% vs 0%）。同步组自体移植的发生率明显低于对照组（26.3% vs. 73.7%, P = 0.041）。来那度胺维持治疗在同步恶性肿瘤患者中的应用不足，反映了可能的临床犹豫。骨髓瘤相关死亡率为17.1%，中位总生存期为48个月（范围：16-80），同步组和既往有实体瘤病史组的生存期无显著差异。结论：NDMM患者同时存在实体瘤与较高的髓外病变发生率相关，并可能影响临床决策，强调需要多学科管理和个性化治疗策略。此外，MM的髓外受累应提示评估潜在的共存实体恶性肿瘤。
{"title":"The Outcomes of Newly Diagnosed Multiple Myeloma Patients With Concurrent or Previous Solid Tumor History","authors":"Yaşa Gül Mutlu , Şerife Emre Ünsal , Buse Güleç , İstemi Serin , Eren Arslan Davulcu , Gülçin Miyase Sönmez , Serkan Güven , Süreyya Yiğit Kaya , Senem Maral , Muzaffer Keklik , Ayşe Salihoğlu , Tugba Cetintepe , Güldane Cengiz Seval , Ömür Gökmen Sevindik","doi":"10.1016/j.clml.2025.10.006","DOIUrl":"10.1016/j.clml.2025.10.006","url":null,"abstract":"<div><h3>Introduction</h3><div>The coexistence of solid tumors and multiple myeloma (MM) presents diagnostic and therapeutic challenges; however, data on clinical outcomes in this population remain limited. This study aimed to evaluate the clinical characteristics and survival outcomes of patients with newly diagnosed multiple myeloma (NDMM) who had synchronous or prior solid tumor malignancies.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 41 NDMM patients with a documented history of solid tumor, classified as either concurrent (diagnosed within 6 months) or prior. Clinical characteristics, treatment patterns, and outcomes were evaluated. Patients were stratified according to the timing of solid tumor diagnosis.</div></div><div><h3>Results</h3><div>The median age was 66 years, with a male predominance (58.5%). Breast (24.4%), lung (17.1%), colon, and prostate cancers (9.8% each) were the most common solid tumors. Extramedullary disease was observed only in the synchronous group (100% vs. 0%). Autologous transplantation was performed significantly less frequently in the synchronous group (26.3% vs. 73.7%, <em>P</em> = 0.041). Lenalidomide maintenance therapy was underutilized in patients with synchronous malignancies, reflecting possible clinical hesitation. Myeloma-related mortality occurred in 17.1% of patients, with a median overall survival of 48 months (range: 16-80), and no significant survival difference between synchronous and patient with prior solid tumor history group.</div></div><div><h3>Conclusion</h3><div>The presence of synchronous solid tumors in NDMM patients is associated with a higher rate of extramedullary disease and may influence clinical decision-making, highlighting the need for multidisciplinary management and individualized treatment strategies. Furthermore, extramedullary involvement in MM should prompt evaluation for a potential coexisting solid malignancy.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 2","pages":"Pages e248-e253"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Proteasome inhibitors (PIs), comprising the first-generation agent bortezomib and the second-generation agents carfilzomib and ixazomib are key therapies for multiple myeloma (MM). This study evaluated the cardiovascular (CV) safety of carfilzomib by comparing outcomes with other PIs in a real-world, propensity score-matched (PSM) cohort.
Methods
A retrospective cohort study was conducted using the TriNetX global health research network. Adults with MM treated with carfilzomib or other PIs were identified, and 1:1 PSM was applied to create balanced cohorts. Outcomes included heart failure (HF), hypertension, atrial fibrillation (AF), myocardial infarction (MI), and stroke, as well as a composite endpoint of all-cause mortality, MI, or stroke (all-cause 3P-MACE).
Results
After PSM, 7776 patients were included in each cohort. The mean age was 70.6 ± 10.6 years in the carfilzomib cohort and 71.1 ± 11.0 years in the non-carfilzomib cohort. The risk of HF (Hazard ratios, HR [95% confidence intervals, 95% CI], 1.40 [1.27-1.55], P = .831), AF (HR [95% CI], 1.08 [0.96-1.20], P = .316), hypertension (HR [95% CI], 1.37 [1.23-1.52], P = .579), MI (338 vs. 368 patients; HR [95% CI], 1.10 [0.95-1.28], P = .719), and stroke (234 vs. 247 patients; HR [95% CI], 1.16 [0.96-1.38], P = .367) did not differ between groups. However, carfilzomib was associated with a significantly increased risk of the all-cause 3P-MACE (HR [95% CI], 1.67 [1.58-1.77], P = .014).
Conclusion
In this large real-world PSM analysis, carfilzomib was not associated with an increased risk of individual CV outcomes compared with other PIs, but it was linked to a higher incidence of all-cause 3P-MACE, underscoring the need for careful CV monitoring.
背景：蛋白酶体抑制剂（pi），包括第一代药物硼替佐米和第二代药物卡非佐米和伊沙唑米是多发性骨髓瘤（MM）的关键治疗药物。本研究通过比较现实世界中倾向评分匹配（PSM）队列与其他pi的结果来评估卡非佐米的心血管（CV）安全性。方法：采用TriNetX全球健康研究网络进行回顾性队列研究。经卡非佐米或其他pi治疗的成年MM患者被确定，1:1 PSM应用于创建平衡队列。结果包括心力衰竭（HF）、高血压、心房颤动（AF）、心肌梗死（MI）和脑卒中，以及全因死亡率、心肌梗死或脑卒中（全因3P-MACE）的复合终点。结果：PSM后，每个队列纳入7776例患者。卡非佐米组的平均年龄为70.6±10.6岁，非卡非佐米组的平均年龄为71.1±11.0岁。HF（风险比，HR[95%可信区间，95% CI], 1.40 [1.27-1.55], P = 0.831）、AF （HR [95% CI], 1.08 [0.96-1.20], P = 0.316）、高血压（HR [95% CI], 1.37 [1.23-1.52], P = 0.579）、MI（338对368例；HR [95% CI], 1.10 [0.95-1.28], P = 0.719）和卒中（234对247例；HR [95% CI], 1.16 [0.96-1.38], P = 0.367）的风险在组间无差异。然而，卡非佐米与全因3P-MACE风险显著增加相关（HR [95% CI], 1.67 [1.58-1.77], P = 0.014）。结论：在这项大型现实世界PSM分析中，与其他pi相比，卡非佐米与个体CV结局风险增加无关，但与全因3P-MACE发生率较高有关，强调了仔细监测CV的必要性。
{"title":"Cardiovascular Safety of Carfilzomib in Patients with Multiple Myeloma","authors":"Anastasios Tentolouris , Ioannis Ntanasis-Stathopoulos , Charalampos Filippatos , Panagiotis Malandrakis , Ernesto Ruiz Duque , Meletios-Athanasios Dimopoulos , Alexandros Briasoulis , Maria Gavriatopoulou","doi":"10.1016/j.clml.2025.10.025","DOIUrl":"10.1016/j.clml.2025.10.025","url":null,"abstract":"<div><h3>Basckground</h3><div>Proteasome inhibitors (PIs), comprising the first-generation agent bortezomib and the second-generation agents carfilzomib and ixazomib are key therapies for multiple myeloma (MM). This study evaluated the cardiovascular (CV) safety of carfilzomib by comparing outcomes with other PIs in a real-world, propensity score-matched (PSM) cohort.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using the TriNetX global health research network. Adults with MM treated with carfilzomib or other PIs were identified, and 1:1 PSM was applied to create balanced cohorts. Outcomes included heart failure (HF), hypertension, atrial fibrillation (AF), myocardial infarction (MI), and stroke, as well as a composite endpoint of all-cause mortality, MI, or stroke (all-cause 3P-MACE).</div></div><div><h3>Results</h3><div>After PSM, 7776 patients were included in each cohort. The mean age was 70.6 ± 10.6 years in the carfilzomib cohort and 71.1 ± 11.0 years in the non-carfilzomib cohort. The risk of HF (Hazard ratios, HR [95% confidence intervals, 95% CI], 1.40 [1.27-1.55], <em>P</em> = .831), AF (HR [95% CI], 1.08 [0.96-1.20], <em>P</em> = .316), hypertension (HR [95% CI], 1.37 [1.23-1.52], <em>P</em> = .579), MI (338 vs. 368 patients; HR [95% CI], 1.10 [0.95-1.28], <em>P</em> = .719), and stroke (234 vs. 247 patients; HR [95% CI], 1.16 [0.96-1.38], <em>P</em> = .367) did not differ between groups. However, carfilzomib was associated with a significantly increased risk of the all-cause 3P-MACE (HR [95% CI], 1.67 [1.58-1.77], <em>P</em> = .014).</div></div><div><h3>Conclusion</h3><div>In this large real-world PSM analysis, carfilzomib was not associated with an increased risk of individual CV outcomes compared with other PIs, but it was linked to a higher incidence of all-cause 3P-MACE, underscoring the need for careful CV monitoring.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 2","pages":"Pages e172-e179"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.clml.2025.08.017
Anas Zayad , Gray Magee , Razan Mansour , Mark Chang , Nausheen Ahmed , Muhammad Umair Mushtaq , Barry Paul , Kimberly M Green , James A Davis , Barry Skikne , Zahra Mahmoud Jafari , Jeries Kort , Shebli Atrash , Al-Ola Abdallah
Background
Daratumumab-based triplet regimens have demonstrated efficacy in relapsed or refractory multiple myeloma (RRMM). However, direct comparisons between these combinations remain limited. This study evaluated the efficacy and safety of 2 such regimens, DPd (daratumumab, pomalidomide, and dexamethasone) and DKd (daratumumab, carfilzomib, and dexamethasone), in a real-world RRMM population.
Methods
We conducted a multicenter retrospective cohort study including 399 patients with RRMM treated at three academic centers in the US. The patients received either DPd (n = 295) or DKd (n = 104). Progression-free survival (PFS), overall survival (OS), depth of response, and adverse event profiles were compared between the groups.
Results
The median PFS was 15 and 12 months in the DPd and DKd groups, respectively. The median OS was 38 months for DPd and was not reached in the DKd cohort. The differences in PFS (P = .2) and OS (P = .5) were not statistically significant. The overall response rates and depth of response were comparable across regimens. DPd was associated with higher rates of hematologic toxicity, particularly grade ≥ 3 neutropenia (36% vs. 23%) and leukopenia (26% vs. 14%), whereas DKd showed a greater incidence of cardiovascular adverse events (29% vs. 18%).
Conclusions
DPd and DKd demonstrated similar clinical efficacies in RRMM patients, although their toxicity profiles differed. These findings highlight the importance of individualized treatment decisions considering underlying patient comorbidities and prior drug exposure. These findings support the use of either regimen in appropriate patient subsets, based on efficacy and distinct safety profiles.
{"title":"Efficacy and Safety of Daratumumab, Pomalidomide and Dexamethasone Compared to Daratumumab, Carfilzomib and Dexamethasone in Relapsed Multiple Myeloma: Multicenter Real-World Experience","authors":"Anas Zayad , Gray Magee , Razan Mansour , Mark Chang , Nausheen Ahmed , Muhammad Umair Mushtaq , Barry Paul , Kimberly M Green , James A Davis , Barry Skikne , Zahra Mahmoud Jafari , Jeries Kort , Shebli Atrash , Al-Ola Abdallah","doi":"10.1016/j.clml.2025.08.017","DOIUrl":"10.1016/j.clml.2025.08.017","url":null,"abstract":"<div><h3>Background</h3><div>Daratumumab-based triplet regimens have demonstrated efficacy in relapsed or refractory multiple myeloma (RRMM). However, direct comparisons between these combinations remain limited. This study evaluated the efficacy and safety of 2 such regimens, DPd (daratumumab, pomalidomide, and dexamethasone) and DKd (daratumumab, carfilzomib, and dexamethasone), in a real-world RRMM population.</div></div><div><h3>Methods</h3><div>We conducted a multicenter retrospective cohort study including 399 patients with RRMM treated at three academic centers in the US. The patients received either DPd (<em>n</em> = 295) or DKd (<em>n</em> = 104). Progression-free survival (PFS), overall survival (OS), depth of response, and adverse event profiles were compared between the groups.</div></div><div><h3>Results</h3><div>The median PFS was 15 and 12 months in the DPd and DKd groups, respectively. The median OS was 38 months for DPd and was not reached in the DKd cohort. The differences in PFS (<em>P</em> = .2) and OS (<em>P</em> = .5) were not statistically significant. The overall response rates and depth of response were comparable across regimens. DPd was associated with higher rates of hematologic toxicity, particularly grade ≥ 3 neutropenia (36% vs. 23%) and leukopenia (26% vs. 14%), whereas DKd showed a greater incidence of cardiovascular adverse events (29% vs. 18%).</div></div><div><h3>Conclusions</h3><div>DPd and DKd demonstrated similar clinical efficacies in RRMM patients, although their toxicity profiles differed. These findings highlight the importance of individualized treatment decisions considering underlying patient comorbidities and prior drug exposure. These findings support the use of either regimen in appropriate patient subsets, based on efficacy and distinct safety profiles.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 2","pages":"Pages 94-105"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.clml.2025.10.007
Mark A Fiala , Eva Lepisto , Chioma Amadi-Mgbenka , Jessica Schulman , George Mulligan , Hearn Jay Cho
Background
This study explored financial toxicity and its association with treatment satisfaction among a longitudinal cohort of patients with multiple myeloma (MM).
Patients and Methods
The multiple myeloma research foundation (MMRF) CureCloud initiative (NCT03657251) is an observational study which collects biospecimens, clinical data, and patient reported outcomes (PROs). Participants completed the Comprehensive Score for Financial Toxicity (COST) and the Cancer Therapy Satisfaction Questionnaire (CTSQ).
Results
At the initial time point, 214 participants completed the PROs. The mean age was 68, 60% were male, and 94% were white. The median time from MM diagnosis to the baseline survey completion was 6 years. The mean COST score was 29 (SD=10) and 37% of the patients were considered to be experiencing financial toxicity. Younger patients (P < .01) and those residing in areas with lower median household incomes (P = .01) were more likely to be experiencing financial toxicity. Participants experiencing financial toxicity reported lower satisfaction with their therapy, with a mean CTSQ score 6.7 points lower than those without (P < .01). A subset of patients (n = 75) completed a second COST survey approximately 1 year later. Financial toxicity status was relatively stable; 67% (18/27) of patients experiencing it at baseline were still at the later time point and only 10% (5/48) of patients previously not experiencing financial toxicity were at the later time point.
Conclusion
Over one-third of patients with MM were considered to be experiencing financial toxicity and financial toxicity was associated with reduced satisfaction with MM treatment.
{"title":"Financial Toxicity and Satisfaction With Cancer Treatment Among Patients With Multiple Myeloma: An Analysis of the MMRF’s CureCloud Initiative","authors":"Mark A Fiala , Eva Lepisto , Chioma Amadi-Mgbenka , Jessica Schulman , George Mulligan , Hearn Jay Cho","doi":"10.1016/j.clml.2025.10.007","DOIUrl":"10.1016/j.clml.2025.10.007","url":null,"abstract":"<div><h3>Background</h3><div>This study explored financial toxicity and its association with treatment satisfaction among a longitudinal cohort of patients with multiple myeloma (MM).</div></div><div><h3>Patients and Methods</h3><div>The multiple myeloma research foundation (MMRF) CureCloud initiative (NCT03657251) is an observational study which collects biospecimens, clinical data, and patient reported outcomes (PROs). Participants completed the Comprehensive Score for Financial Toxicity (COST) and the Cancer Therapy Satisfaction Questionnaire (CTSQ).</div></div><div><h3>Results</h3><div>At the initial time point, 214 participants completed the PROs. The mean age was 68, 60% were male, and 94% were white. The median time from MM diagnosis to the baseline survey completion was 6 years. The mean COST score was 29 (SD=10) and 37% of the patients were considered to be experiencing financial toxicity. Younger patients (<em>P</em> < .01) and those residing in areas with lower median household incomes (<em>P</em> = .01) were more likely to be experiencing financial toxicity. Participants experiencing financial toxicity reported lower satisfaction with their therapy, with a mean CTSQ score 6.7 points lower than those without (<em>P</em> < .01). A subset of patients (<em>n</em> = 75) completed a second COST survey approximately 1 year later. Financial toxicity status was relatively stable; 67% (18/27) of patients experiencing it at baseline were still at the later time point and only 10% (5/48) of patients previously not experiencing financial toxicity were at the later time point.</div></div><div><h3>Conclusion</h3><div>Over one-third of patients with MM were considered to be experiencing financial toxicity and financial toxicity was associated with reduced satisfaction with MM treatment.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 2","pages":"Pages e254-e260"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.clml.2025.10.008
Inés Martínez-Alfonzo , Diego Velasco-Rodríguez , Pablo Mínguez-Paniagua , Ignacio Mahillo-Fernández , Laura Fernández-Cuezva , Alberto Velasco-Valdazo , Rosa Vidal-Laso , Cristina Fernández Maqueda , Sara Martín-Herrero , Nuria Revilla , Ana Camila González-Teomiro , María Civeira-Marín , Elena Prieto , Amalia Domingo-González , Carlos Soto , Jose M Calvo-Villas , Elham Askari , Pilar Llamas-Sillero , Juana Serrano-López
Background
Venous thromboembolism (VTE) is an important complication in newly diagnosed multiple myeloma (NDMM), particularly during the first year after diagnosis. Existing risk assessment models show limited predictive accuracy. This study developed a novel risk scoring system using complementary approaches to improve VTE risk prediction in NDMM.
Methods
We retrospectively analyzed 225 NDMM patients from 4 hospitals (2014-2019) to develop a prediction score for first-year VTE. The model was built using Least Absolute Shrinkage and Selection Operator (LASSO) regularization with variables showing P < .25 in univariate analysis. Performance was assessed using area under the curve (AUC) and Hosmer-Lemeshow test. IMPEDE-VTE and SAVED scores were calculated for comparison.
Results
Among 225 patients (median age 68 years), 32 (14%) developed VTE, predominantly pulmonary embolism (71%) within the first year after diagnosis. The LASSO model had a c-statistic of 0.86 and identified ECOG ≥ 1, high R-ISS stage, high-dose dexamethasone (> 160 mg per cycle), Lactate dehydrogenase (LDH) > 370 IU/L, immunoparesis, spinal cord compression, and paralysis as independent predictors (AUC: 0.86). LASSO-derived PREVEMM score significantly outperformed existing tools (AUC: 0.88 vs 0.61 for both IMPEDE-VTE and SAVED).
Conclusion
PREVEMM score demonstrates superior VTE risk stratification capabilities, supporting its potential clinical utility for individualized thromboprophylaxis in NDMM.
{"title":"Development of PREVEMM: A Venous Thromboembolism Risk Score for Newly Diagnosed Multiple Myeloma Patients","authors":"Inés Martínez-Alfonzo , Diego Velasco-Rodríguez , Pablo Mínguez-Paniagua , Ignacio Mahillo-Fernández , Laura Fernández-Cuezva , Alberto Velasco-Valdazo , Rosa Vidal-Laso , Cristina Fernández Maqueda , Sara Martín-Herrero , Nuria Revilla , Ana Camila González-Teomiro , María Civeira-Marín , Elena Prieto , Amalia Domingo-González , Carlos Soto , Jose M Calvo-Villas , Elham Askari , Pilar Llamas-Sillero , Juana Serrano-López","doi":"10.1016/j.clml.2025.10.008","DOIUrl":"10.1016/j.clml.2025.10.008","url":null,"abstract":"<div><h3>Background</h3><div>Venous thromboembolism (VTE) is an important complication in newly diagnosed multiple myeloma (NDMM), particularly during the first year after diagnosis. Existing risk assessment models show limited predictive accuracy. This study developed a novel risk scoring system using complementary approaches to improve VTE risk prediction in NDMM.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 225 NDMM patients from 4 hospitals (2014-2019) to develop a prediction score for first-year VTE. The model was built using Least Absolute Shrinkage and Selection Operator (LASSO) regularization with variables showing <em>P</em> < .25 in univariate analysis. Performance was assessed using area under the curve (AUC) and Hosmer-Lemeshow test. IMPEDE-VTE and SAVED scores were calculated for comparison.</div></div><div><h3>Results</h3><div>Among 225 patients (median age 68 years), 32 (14%) developed VTE, predominantly pulmonary embolism (71%) within the first year after diagnosis. The LASSO model had a c-statistic of 0.86 and identified ECOG ≥ 1, high R-ISS stage, high-dose dexamethasone (> 160 mg per cycle), Lactate dehydrogenase (LDH) > 370 IU/L, immunoparesis, spinal cord compression, and paralysis as independent predictors (AUC: 0.86). LASSO-derived PREVEMM score significantly outperformed existing tools (AUC: 0.88 vs 0.61 for both IMPEDE-VTE and SAVED).</div></div><div><h3>Conclusion</h3><div>PREVEMM score demonstrates superior VTE risk stratification capabilities, supporting its potential clinical utility for individualized thromboprophylaxis in NDMM.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 2","pages":"Pages e266-e274.e8"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145430426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.clml.2025.08.005
Sikander Ailawadhi , Larry D. Anderson Jr , Binod Dhakal , Leyla Shune , Douglas W. Sborov , Doris K. Hansen
Autologous chimeric antigen receptor T-cell (CAR-T) therapies have become a key component of the multiple myeloma (MM) treatment landscape. Most patients treated with CAR-T therapies for MM receive bridging therapy to reduce tumor burden prior to CAR-T administration. These treatments are highly individualized, with selection informed by disease characteristics and treatment history, among other factors. While pivotal clinical trials restricted use of bridging therapy to specific regimens, a wide variety of anti-myeloma therapies have been used in real-world settings. Given potential variability in use of specific bridging regimens, there is a need for expert guidance on selection and use of these therapies in patients receiving CAR-T therapy for MM. This review aims to provide an overview of key considerations influencing bridging therapy selection and to outline practical guidance for selection of bridging therapy across patient populations. With expanded indications and earlier referrals for patients to receive CAR-T therapy for MM, continued collaboration with experienced CAR-T providers will be instrumental in optimizing administration of bridging therapy and improving overall patient outcomes.
{"title":"Optimizing Selection of Bridging Therapies Prior to CAR-T Therapy Administration for Multiple Myeloma: Clinical Pearls From an Expert Roundtable","authors":"Sikander Ailawadhi , Larry D. Anderson Jr , Binod Dhakal , Leyla Shune , Douglas W. Sborov , Doris K. Hansen","doi":"10.1016/j.clml.2025.08.005","DOIUrl":"10.1016/j.clml.2025.08.005","url":null,"abstract":"<div><div>Autologous chimeric antigen receptor T-cell (CAR-T) therapies have become a key component of the multiple myeloma (MM) treatment landscape. Most patients treated with CAR-T therapies for MM receive bridging therapy to reduce tumor burden prior to CAR-T administration. These treatments are highly individualized, with selection informed by disease characteristics and treatment history, among other factors. While pivotal clinical trials restricted use of bridging therapy to specific regimens, a wide variety of anti-myeloma therapies have been used in real-world settings. Given potential variability in use of specific bridging regimens, there is a need for expert guidance on selection and use of these therapies in patients receiving CAR-T therapy for MM. This review aims to provide an overview of key considerations influencing bridging therapy selection and to outline practical guidance for selection of bridging therapy across patient populations. With expanded indications and earlier referrals for patients to receive CAR-T therapy for MM, continued collaboration with experienced CAR-T providers will be instrumental in optimizing administration of bridging therapy and improving overall patient outcomes.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 2","pages":"Pages 85-93"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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