Citations 1
Real-World Outcomes with BCMA- and GPRC5D-Targeting Bispecific Antibodies in Plasma Cell Leukemia
Gaballa, Mahmoud R. , Julian, Kelley , Afrough, Aimaz , Hansen, Doris K. , Goel, Utkarsh , Corraes, Andre De Menezes Silva, Dima, Danai , Rana, Masooma , Hosoya, Hitomi , Mikkilineni, Lekha , Fogel, Lindsay , Raza, Shahzad, Zanwar, Saurabh , Sannareddy, Aishwarya, Borogovac, Azra , Green, Kimberly M , Biran, Noa, Shune, Leyla, Ouchveridze, Evguenia, DeJarnette, Shaun, Ferreri, Christopher J, Richards, Tiffany, Bal, Susan , Ye, Jing Christine, Shain, Kenneth H. , Harada, Ken , Avila, Gabriel De, Voorhees, Peter, Khouri, Jack , Sidana, Surbhi , Lin, Yi, Patel, Krina K. , Sborov, Douglas W. , Gaballa, Mahmoud , De Menezes Silva Corraes, Andre , Banerjee, Rahul , Zanwar, Saurabh S , Borogovac, Azra , Davis, James A , Green, Kimberly , Zolotov, Eli , Herr, Megan M. , Abid, Muhammad Bilal , Bal, Susan , Ali, Hossam M , Kaur, Gurbakhash , Shain, Kenneth H , Castaneda Puglianini, Omar , Hassan, Hamza , Anderson, Larry D , Khouri, Jack , Sidana, Surbhi , Portuguese, Andrew J , Janakiram, Murali , Lee, Hans C , Patel, Krina , Sborov, Douglas W , Dima, Danai , Hosoya, Hitomi , Rana, Masooma S , Julian, Kelley L , Hansen, Doris K , Corraes, Andre De Menezes Silva , Raza, Shahzad , Banerjee, Rahul , Pasvolsky, Oren , Sannareddy, Aishwarya , Davis, James A. , Biran, Noa , Zolotov, Eli , Shune, Leyla , Atrash, Shebli , Ferreri, Christopher J. , Richards, Tiffany, Abid, Muhammad Bilal , Ali, Hossam M. , Ye, Jing Christine, Richard, Shambavi , Kaur, Gurbakhash , Puglianini, Omar Castañeda , Rossi, Adriana , Hassan, Hamza , Anderson, Larry D. , Voorhees, Peter M. , Portuguese, Andrew J. , Janakiram, Murali , Lee, Hans C. , Grajales‐Cruz, Ariel
Blood Advances | July 2, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
10.1182/bloodadvances.2026020826
Patients with plasma cell leukemia (PCL) are generally excluded from pivotal T-cell redirecting bispecific antibody (BsAb) trials. We evaluated real-world outcomes in a multicenter retrospective study of 122 patients with primary or secondary PCL across 15 academic centers, categorized as 'active' (≥5% circulating plasma cells within 30 days of BsAb initiation) or 'historical'. In a heavily pretreated population, patients received teclistamab (37%), elranatamab (11%), talquetamab as a line of therapy (Tal LOT, 42%), or talquetamab as bridging therapy to CAR-T (Tal Bridge, 11%). Cytokine release syndrome (CRS) was grade 1-2 in 56% and grade 3-4 in 4%, whereas neurotoxicity was grade 1-2 in 16% and grade 3-4 in 5%. Among 110 evaluable patients, the overall response rate (ORR) was 55%, including 61% with Tal LOT, 58% with Tal Bridge, 46% with elranatamab, and 33% with teclistamab. With a median follow-up of 8.3 months, talquetamab demonstrated superior survival. Tal LOT showed a median progression-free survival (mPFS) of 5.5 months and a median overall survival (mOS) of 11.5 months, and both were unreached in the Tal Bridge cohort. In contrast, teclistamab and elranatamab showed a mPFS of 1.2 and 1.6 months and mOS of 8.1 and 3.6 months, respectively (P=0.007, P=0.023). In active PCL, Tal LOT achieved mPFS/mOS of 6.9/12.2 months versus 0.7/1.4 months with teclistamab and 1.0/3.1 months with elranatamab, respectively (P<0.001, P=0.002). Multivariable analysis associated active PCL with worse survival and Tal LOT with improved outcomes. BsAbs were safe in PCL, with talquetamab showing superior outcomes compared with BCMA-directed BsAbs.