Logo image
Back
MM-846: Treatment-Related Mortality and Predictors in Real-World Patients With Relapsed/Refractory Multiple Myeloma Treated With Teclistamab
Abstract   Peer reviewed

MM-846: Treatment-Related Mortality and Predictors in Real-World Patients With Relapsed/Refractory Multiple Myeloma Treated With Teclistamab

Osama Younis, Sencer Goklemez, Carmel Awadallah, Barry Paul, Hira Shaikh, Christopher Strouse, Anita Mazloom, Omar Alkharabsheh, Prerna Mewawalla, Mansi Shah, …
Clinical lymphoma, myeloma and leukemia, Vol.26(Supplement 1), pp.S1120-S1121
08/2026
DOI: 10.1016/S2152-2650(26)02942-3

View Online

Abstract

Background: Teclistamab has demonstrated meaningful activity in relapsed/refractory multiple myeloma (RRMM), but treatment-related mortality (TRM) remains an important real-world safety concern. Although most deaths after bispecific T-cell engager therapy are attributed to progressive disease, a clinically relevant subset may be treatment-related. We evaluated the incidence of TRM in a multicenter, real-world teclistamab cohort and assessed whether baseline predictors of mortality also identify patients at increased risk for TRM. Methods: We performed a retrospective analysis of a US multicenter registry of patients with RRMM treated with teclistamab. TRM was defined using the site-recorded, treatment-related death flag. Given the rarity of TRM events, associations were evaluated using Firth penalized logistic regression. Multivariable models were limited to three variables at a time. Results: Among 163 evaluable patients, 57 deaths occurred, of which 10 were treatment-related, representing 17.5% of deaths and 6.1% of the overall cohort. On univariable analysis, TRM was associated with baseline hemoglobin <8 g/dL (odds ratio [OR], 11.3; 95% confidence interval [CI], 3.1–49.4; P = 0.0002), on-treatment severe infection (OR, 11.3; 95% CI, 2.8–63.7; P = 0.0005), extramedullary disease (OR, 5.6; 95% CI, 1.6–24.1; P = 0.007), and baseline platelets <75 × 109/L (OR, 4.4; 95% CI, 1.2–15.9; P = 0.024). Intravenous immunoglobulin (IVIG) was associated with lower TRM odds (OR, 0.15; 95% CI, 0.02–0.67; P = 0.010). In the primary multivariable model, hemoglobin <8 g/dL (adjusted OR, 9.3; 95% CI, 1.9–52.3; P = 0.007) and extramedullary disease (adjusted OR, 4.1; 95% CI, 1.1–19.1; P = 0.042) remained independently associated with TRM, whereas platelets <75 × 109/L did not. In the secondary model, including severe infection and excluding platelets <75 × 109/L, hemoglobin <8 g/dL and severe infection remained dominant predictors, while extramedullary disease was attenuated. Conclusions: In this real-world teclistamab cohort, approximately one in six deaths was treatment-related. Baseline marrow frailty, particularly severe anemia, and extramedullary disease identified patients at increased TRM risk. The strong association between severe infection and TRM highlights the overlap among baseline vulnerability, infectious toxicity, and treatment-related death. Prospective studies with standardized event dating and central adjudication are needed to refine TRM attribution and riskmitigation strategies.
 BiTE multiple myeloma teclistamab treatment-related mortality TRM

Details

Metrics

1 Record Views
Logo image