Kayıhan Kara

Background: Elranatamab, a bispecific antibody targeting BCMA and CD3, has demonstrated clinical activity in relapsed/refractory multiple myeloma. Real-world evidence regarding infectious complications and supportive care remains limited. We evaluated the early clinical activity, safety profile, infectious complications, and supportive care practices associated with relapsed/refractory multiple myeloma (RRMM). This study represents one of the first multicenter real-world evaluations of elranatamab in Türkiye. Methods: This multicenter retrospective study included 87 patients with relapsed/refractory multiple myeloma treated with elranatamab. Clinical characteristics, treatment responses, immune-mediated toxicities, infectious complications, and supportive care practices were assessed. Overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) were evaluated. Multivariable analyses were performed to identify factors associated with treatment response and clinical outcomes. Results: At 3 months, ORR was 47.1% in the ITT population, 54.7% in the mITT population, and 83.7% among evaluable patients; corresponding 6-month ORRs were 31.0%, 42.2%, and 81.8%, respectively. The high proportion of patients without landmark response assessments primarily reflected insufficient follow-up, early death, or disease progression. Elevated LDH remained independently associated with lower response probability and inferior clinical outcomes. Cytokine release syndrome (CRS) occurred in 69% of patients, with grade ≥ 3 events in 5.7%, whereas immune effector cell-associated neurotoxicity syndrome (ICANS) was infrequent (4.6%) and no grade ≥ 3 events occurred. Grade ≥ 3 infections occurred in 39% of patients, including CMV events requiring antiviral treatment in 24.1%. No HBV reactivation occurred among patients receiving antiviral prophylaxis. Median PFS and OS were 8.1 and 10.6 months, respectively. Conclusions: Elranatamab demonstrated early clinical activity and a manageable safety profile in a heavily pretreated real-world RRMM population. Infectious complications, including CMV events, remained clinically relevant, emphasizing the importance of supportive care. Longer follow-up is needed to characterize long-term outcomes.

Objective: Imatinib mesylate, a tyrosine kinase inhibitor (TKI), has revolutionized CML treatment, improving patient survival to levels comparable to the general population. This study evaluates treatment response, side effects, and survival rates in CML patients followed at our clinic. Materials and Methods: A retrospective analysis was conducted on 76 CML patients treated with imatinib at ………. University Hospital between August 2000 and April 2022. Treatment responses, side effects, and survival outcomes were assessed. Results: The median age of patients was 49 years, with 93.4% in the chronic phase and 6.6% in the accelerated phase. Patients achieving MMR at the 6th month had significantly longer event-free survival (EFS) (198.09 ± 12.39 months; p<0.0001). The 10-year overall survival (OS) rate was 94.2%, and the 5-year OS rate was 98.5%. A total of 46.05% of patients were switched to second-generation TKIs due to insufficient response or side effects. Cox regression analysis revealed that older age at diagnosis increased the risk of death, and failure to achieve MMR at the 12th month raised event risk by 76-fold. During treatment, 30.3% of patients experienced imatinib-related side effects, with serious side effects observed in 9.2% of patients. Conclusion: Imatinib remains a highly effective and well-tolerated treatment for CML in real-world settings. The outcomes observed in this study aligned similarly with those reported in international clinical trials. Achieving early molecular responses significantly improves long-term survival. These findings underscore the importance of adherence to treatment protocols and regular monitoring.