International journal of hematology · 2025
Outcomes of elranatamab in relapsed/refractory multiple myeloma: prognostic impact of monocyte count, MyCARe, and R2-ISS.
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Kikuchi Taku, Sugita Shotaro, Kondo Ukyo, Watanabe Miyu, Matsumoto Chiaki, Nomura-Yogo Moe, Kunisada Kodai, Sato Kota, Takei Tomomi, Ogura Mizuki, Abe Yu, Hosoya Osamu, Ishida Tadao, Tsukada Nobuhiro
Аннотация
BACKGROUND: Elranatamab, a bispecific antibody targeting B-cell maturation antigen and CD3, has demonstrated efficacy in relapsed/refractory multiple myeloma (RRMM). However, real-world evidence is limited, and prognostic factors have not been sufficiently evaluated.
METHODS: We retrospectively analyzed patients with RRMM receiving elranatamab between June 2024 and July 2025. Responses were assessed using the International Myeloma Working Group criteria. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Prognostic factors were evaluated using univariate log-rank analysis, including R2-ISS at elranatamab initiation (dynamic R2-ISS) and modified MyCARe risk, with positivity defined as any detectable plasma cells in peripheral blood.
RESULTS: Thirty-seven patients were evaluated (median age, 67 years; prior lines, 5). Median follow-up was 7.5 (median PFS, 9.7) months. One-year OS was 66.3%. The overall response rate was 67.6%, and 45.9% achieved at least a very good partial response. Extramedullary disease, plasma cells in the peripheral blood, and high-risk cytogenetics were adverse features. A baseline monocyte count < 300/µL, high-risk classification by modified MyCARe, and dynamic R2-ISS stage IV were significantly associated with shorter PFS and OS.
CONCLUSION: Elranatamab was effective in real-world settings. Baseline monocyte count, modified MyCARe risk, and dynamic R2-ISS may serve as practical prognostic tools.
METHODS: We retrospectively analyzed patients with RRMM receiving elranatamab between June 2024 and July 2025. Responses were assessed using the International Myeloma Working Group criteria. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Prognostic factors were evaluated using univariate log-rank analysis, including R2-ISS at elranatamab initiation (dynamic R2-ISS) and modified MyCARe risk, with positivity defined as any detectable plasma cells in peripheral blood.
RESULTS: Thirty-seven patients were evaluated (median age, 67 years; prior lines, 5). Median follow-up was 7.5 (median PFS, 9.7) months. One-year OS was 66.3%. The overall response rate was 67.6%, and 45.9% achieved at least a very good partial response. Extramedullary disease, plasma cells in the peripheral blood, and high-risk cytogenetics were adverse features. A baseline monocyte count < 300/µL, high-risk classification by modified MyCARe, and dynamic R2-ISS stage IV were significantly associated with shorter PFS and OS.
CONCLUSION: Elranatamab was effective in real-world settings. Baseline monocyte count, modified MyCARe risk, and dynamic R2-ISS may serve as practical prognostic tools.