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4739 Teclistamab in Relapsed Refractory Multiple Myeloma Patients on Dialysis: A French Experience

Program: Oral and Poster Abstracts
Session: 652. Multiple Myeloma: Clinical and Epidemiological: Poster III
Hematology Disease Topics & Pathways:
Biological therapies, Clinical Practice (Health Services and Quality), Bispecific Antibody Therapy, Plasma Cell Disorders, Diseases, Therapies, Lymphoid Malignancies
Monday, December 11, 2023, 6:00 PM-8:00 PM

Florence Lachenal, MD1*, Pierre Lebreton, MD2*, Sylvie Bouillie, PhD3*, Gian Matteo Pica, MD4*, Hassina Aftisse, MD5*, Laurent Pascal, MD6, Lydia Montes, MD7*, Margaret Macro, MD8*, Marguerite Vignon, MD9*, Stephanie Harel, MD10*, Mariana Fernandez11*, Chanaz Louni12*, Antoine Huart, MD13* and Aurore Perrot, MD, PhD14

1GHND Groupement Hospitalier Nord Dauphiné, Bourgoin Jallieu, France
2Groupe Hospitalier du Havre, Le Havre, France
3Janssen, Issy-les-Moulineaux, France
4Hematology department, CH Chambery, Chambery, France
5Centre Hospitalier de Saint Quentin, Saint Quentin, France
6Hôpital Saint Vincent de Paul, Lille, France
7Service d’Hématologie Clinique, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
8Hopital Cote De Nacre, Caen, France
9Hématologie Clinique, Hôpital Cochin, AP-HP, Paris, France
10Saint Louis Hospital, Paris, France
11Janssen Cilag Spain, Madrid, Spain
12IFM, Paris, France
13Department of Nephrology and Transplantation, CHU de Toulouse Rangueil, Toulouse, France
14CHU de Toulouse, IUCT-O, Université de Toulouse, UPS, Service d’Hématologie, Toulouse, France


Up to 50% of patients with multiple myeloma (MM) have renal impairment at diagnosis; about 5% require dialysis. Prognosis of these patients remains significantly worse and associated with early death. Teclistamab is a humanized immunoglobulin bispecific antibody directed against the BCMA and CD3 receptors and demonstrated clinical benefit as monotherapy for the treatment of patients with relapsed/refractory MM (RRMM) who have received at least 3 prior therapies, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 antibody. However, data in patients with dialysis-dependent renal failure are missing. Here, we report safety and efficacy data from RRMM patients treated with teclistamab in a dialysis setting.


This retrospective study included RRMM patients with end-stage renal failure requiring dialysis treated with teclistamab in French Acces Précoce program. Teclistamab was given every week at dose of 1.5 mg/kg subcutaneously after step-doses of 0.06 and 0.3 mg/kg. Premedication (including dexamethasone for step up doses and first full dose) were administered before teclistamab administration according the FDA and EMA recommendations. Teclistamab was administered after dialysis, but precise schedules vary slightly according to the rhythm of dialysis of each patient.


To date, 13 patients with end-stage renal failure requiring dialysis have been treated with teclistamab in French hospitals. The median age was 67 years [59-83]. Median time since diagnosis was 6 years [2-9]. The median number of previous lines of therapy was 4 [3-9]. Most of the patients had a myeloma-related end-stage renal failure. Isotype of myeloma was free light chains in 75% of cases.

Step-up dosing modalities were similar to the patients with normal renal function with the only difference being that teclistamab is administered within 1-2 days after dialysis. Half of the patients developed cytokine release syndrome grade 1 or 2, treated with tocilizumab, and addition of dexamethasone for one patient. No ICANS was reported. The infection rate seems not to be superior to non-dialysis patients with only grade < 3 events, except for one patient who presented a severe Covid infection and a pseudomonas aeruginosa bacteriemia, both resolved after short break of teclistamab and specific treatments.

Taking precautions when interpreting such a small cohort, all evaluable patients responded and obtained a VGPR or better. With a median follow-up of 4 months, no progression or deaths were reported. Updated data will be presented during the meeting.


These first results suggest that teclistamab is a feasible, effective and safe option for patients with RRMM who need dialysis. These data are very important for such subgroup of patients typically excluded from clinical trials and for CAR T cell therapies that usually requires fludarabine-based lymphodepletion.

Disclosures: Bouillie: Janssen: Current Employment. Macro: GSK, Sanofi: Honoraria; Janssen, Takeda: Honoraria, Other: Travel/accommodation, Research Funding. Fernandez: Janssen: Current Employment. Perrot: Abbvie, Adaptive, Amgen, BMS, Janssen, Pfizer, Sanofi, Takeda: Honoraria.

*signifies non-member of ASH