A Case Report Supporting the Use of Teclistamab in Multiple Myeloma With CNS Involvement
Abstract
Central nervous system involvement in multiple myeloma (MM‐CNS) is a condition with poor prognosis and no clear treatment options. Standard regimens, including proteasome inhibitors (PIs) and immunomodulatory (IMiD) agents, provide minimal benefit in this setting, highlighting the need for novel therapies. Teclistamab, a bispecific T‐cell engager (BiTE) targeting B‐cell maturation agent (BCMA) and CD3, has demonstrated robust systemic activity in heavily pretreated MM but its role in CNS disease remains undefined, as patients with CNS involvement have been excluded from pivotal trials. We present the case of a 62‐year‐old female with high‐risk MM who developed extensive leptomeningeal myelomatosis following multiple lines of therapy including autologous transplantation, PI‐ and IMiD‐based regimens, and palliative radiotherapy. Upon presentation with confusion, aphasia, and ataxia, MRI revealed diffuse leptomeningeal enhancement. The patient elected to proceed with teclistamab therapy. Following two cycles, she achieved a very good partial serologic response and MRI demonstrated marked radiologic improvement with resolution of cerebellar nodularity and sulcal enhancement. However, functional recovery was not observed, and the treatment was discontinued after three cycles due to clinical decline and infectious complications. She subsequently transitioned to supportive care and passed away 1 month later. This case report documents one of the first reports of teclistamab…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Improving the translation of search strategies using the Polyglot Search Translator: a randomized controlled trial
- Nutritional, Physical, Cognitive, and Combination Interventions and Frailty Reversal Among Older Adults: A Randomized Controlled Trial
- Clinical characteristics and risk factors associated with COVID-19 severity in patients with haematological malignancies in Italy: a retrospective, multicentre, cohort study
- A randomized, controlled trial of oral propranolol in infantile hemangioma
- Clinical phenotypes of delirium during critical illness and severity of subsequent long-term cognitive impairment: a prospective cohort study
- Increased physical activity improves sleep and mood outcomes in inactive people with insomnia: a randomized controlled trial
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.