{"title":"双特异性抗体在复发多发性骨髓瘤腹膜透析患者中的应用。","authors":"Heng Jiang, Yagya Ahlawat, Amir Steinberg","doi":"10.1177/10781552251341235","DOIUrl":null,"url":null,"abstract":"<p><p>IntroductionBispecific antibodies (BsAbs) are a promising therapy for relapsed/refractory multiple myeloma (RRMM), but their efficacy in patients with end-stage renal disease (ESRD) on peritoneal dialysis (PD) remains unclear. Given the prevalence of renal impairment in MM, understanding BsAbs' use in this population is critical.Case ReportWe present a 72-year-old woman with ESRD on PD diagnosed with RRMM after developing a pathologic humeral fracture. Bone marrow biopsy confirmed lambda light chain multiple myeloma with extensive skeletal involvement.Management & OutcomeThe patient was treated with upfront radiation, and then received daratumumab, cyclophosphamide, bortezomib, and dexamethasone (Dara-CyBorD), followed by carfilzomib, lenalidomide, and dexamethasone (KRd) upon progression. Due to limited response, teclistamab was initiated, achieving a significant but transient response, prompting a switch to talquetamab. Following relapse, she was transitioned to elotuzumab, pomalidomide, and dexamethasone, then selinexor as a bridge to chimeric antigen receptor T-cell (CAR-T) therapy.DiscussionThis case demonstrates that BsAbs may be effective in RRMM patients on PD, though responses were transient. Further research is needed to explore BsAbs' pharmacokinetics, optimal dosing, and long-term outcomes in dialysis-dependent MM patients.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251341235"},"PeriodicalIF":1.0000,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Using bispecific antibodies in a patient with peritoneal dialysis for relapsed multiple myeloma.\",\"authors\":\"Heng Jiang, Yagya Ahlawat, Amir Steinberg\",\"doi\":\"10.1177/10781552251341235\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>IntroductionBispecific antibodies (BsAbs) are a promising therapy for relapsed/refractory multiple myeloma (RRMM), but their efficacy in patients with end-stage renal disease (ESRD) on peritoneal dialysis (PD) remains unclear. Given the prevalence of renal impairment in MM, understanding BsAbs' use in this population is critical.Case ReportWe present a 72-year-old woman with ESRD on PD diagnosed with RRMM after developing a pathologic humeral fracture. Bone marrow biopsy confirmed lambda light chain multiple myeloma with extensive skeletal involvement.Management & OutcomeThe patient was treated with upfront radiation, and then received daratumumab, cyclophosphamide, bortezomib, and dexamethasone (Dara-CyBorD), followed by carfilzomib, lenalidomide, and dexamethasone (KRd) upon progression. Due to limited response, teclistamab was initiated, achieving a significant but transient response, prompting a switch to talquetamab. Following relapse, she was transitioned to elotuzumab, pomalidomide, and dexamethasone, then selinexor as a bridge to chimeric antigen receptor T-cell (CAR-T) therapy.DiscussionThis case demonstrates that BsAbs may be effective in RRMM patients on PD, though responses were transient. Further research is needed to explore BsAbs' pharmacokinetics, optimal dosing, and long-term outcomes in dialysis-dependent MM patients.</p>\",\"PeriodicalId\":16637,\"journal\":{\"name\":\"Journal of Oncology Pharmacy Practice\",\"volume\":\" \",\"pages\":\"10781552251341235\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2025-05-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Oncology Pharmacy Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/10781552251341235\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Oncology Pharmacy Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10781552251341235","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
Using bispecific antibodies in a patient with peritoneal dialysis for relapsed multiple myeloma.
IntroductionBispecific antibodies (BsAbs) are a promising therapy for relapsed/refractory multiple myeloma (RRMM), but their efficacy in patients with end-stage renal disease (ESRD) on peritoneal dialysis (PD) remains unclear. Given the prevalence of renal impairment in MM, understanding BsAbs' use in this population is critical.Case ReportWe present a 72-year-old woman with ESRD on PD diagnosed with RRMM after developing a pathologic humeral fracture. Bone marrow biopsy confirmed lambda light chain multiple myeloma with extensive skeletal involvement.Management & OutcomeThe patient was treated with upfront radiation, and then received daratumumab, cyclophosphamide, bortezomib, and dexamethasone (Dara-CyBorD), followed by carfilzomib, lenalidomide, and dexamethasone (KRd) upon progression. Due to limited response, teclistamab was initiated, achieving a significant but transient response, prompting a switch to talquetamab. Following relapse, she was transitioned to elotuzumab, pomalidomide, and dexamethasone, then selinexor as a bridge to chimeric antigen receptor T-cell (CAR-T) therapy.DiscussionThis case demonstrates that BsAbs may be effective in RRMM patients on PD, though responses were transient. Further research is needed to explore BsAbs' pharmacokinetics, optimal dosing, and long-term outcomes in dialysis-dependent MM patients.
期刊介绍:
Journal of Oncology Pharmacy Practice is a peer-reviewed scholarly journal dedicated to educating health professionals about providing pharmaceutical care to patients with cancer. It is the official publication of the International Society for Oncology Pharmacy Practitioners (ISOPP). Publishing pertinent case reports and consensus guidelines...