Simon Zhen

Of baseline characteristics, treatment regimens, hematologic and cardiac responses, and survival outcomes among 51 patients with Mayo stage IIIb AL amyloidosis treated with daratumumab-based frontline therapy.

Talquetamab is a first-in-class GPRC5DxCD3 bispecific antibody approved for heavily pretreated relapsed/refractory multiple myeloma (RRMM), and this multicenter retrospective analysis of 114 RRMM patients treated between October 2023 and January 2025 demonstrated significant efficacy in a heavily pretreated population with median 6 prior therapies. All patients were triple-class refractory, 79% were penta-refractory, and 65% had received prior BCMA-targeted therapy. The overall response rate was 73%, including complete response in 26% and very good partial response in 26%, with six-month progression-free and overall survival rates of 56 and 86% respectively and median progression-free survival of 10 months. Common adverse events included cytokine release syndrome (CRS; 54% with grade ≥2 in 7.3%), infections (27%), and immune effector cell-associated neurotoxicity syndrome (9.8%). The 3-month cumulative infection incidence of 14% for both bacterial and viral infections, where 59% were viral and 41% bacterial, grade ≥3 infections occurred in 18%, and intravenous immunoglobulin was used in 61% of patients. Significant weight loss was observed, with a mean 8.8% decrease at 6 months. This real-world analysis confirms talquetamab’s efficacy in heavily pretreated RRMM while highlighting notable toxicities, including progressive weight loss and infections, which require rigorous monitoring and proactive supportive care.

Primary stroke prevention in non-valvular atrial fibrillation (NVAF) is primarily with non-vitamin K oral anticoagulant (NOAC) therapy. However, 20–36% of ischaemic strokes seem to occur in patients with atrial fibrillation while already on anticoagulation. We present a case of an ischaemic stroke in an elderly female in her 70s with medical history significant for hypertension and NVAF. She had a CHA2DS2-VASc score of 3 and was on apixaban for thromboprophylaxis. She presented with neurological deficits consistent with a left middle cerebral artery stroke, confirmed via head imaging; the most likely stroke aetiology was determined to be cardioembolic in the setting of NVAF. She was treated with continuation of her apixaban at the same dosage. She displayed improved function, although with residual expressive aphasia at her 2-month neurology follow-up. Cardioembolic ischaemic stroke in NVAF despite current NOAC therapy does not have current management guidelines.

Ovarian vein thrombosis (OVT) is a rare thromboembolic condition largely involving the right ovarian vein. Risk factors include pregnancy/ peripartum period, oestrogen therapy, recent surgery or hospitalisation, malignancy, pelvic inflammatory diseases, and thrombophilia; OVT without risk factors is considered idiopathic. We present a rare case of idiopathic left-sided OVT in a post-menopausal woman in her 60s with insignificant past medical history and no identifiable risk factors. She presented with isolated left -lower -quadrant abdominal pain ultimately found to have OVT on computed tomography (CT) scan and confirmed with magnetic resonance imaging (MRI). The patient was initially treated with low-molecular-weight heparin and then transitioned to apixaban. She remained symptom-free at 3-month follow-up. Five previous cases of idiopathic left-sided OVT have been reported to-date, but this is the first case in a postmenopausal woman that has not been associated with hypercoagulable risk factors nor further thromboembolic complications.