At the end of every month, the International Myeloma Foundation Newsroom will feature a wrap-up of some of the most fascinating studies about multiple myeloma from medical journals. Here is the April 2026 edition.

The IMF team of medical editors has provided overviews of key studies. Yet, we encourage you to visit the actual articles in the journals for full details and to increase your understanding. Check the IMF Newsroom monthly for updates like this one.

In the Journals (Key Myeloma Research in April 2026)

"CD138-targeted bispecific protein engager-armed T cells exhibit potent and selective cytotoxicity against multiple myeloma cells"

Source

Pucharee Songprakhon, Piriya Luangwattananun, Kornkan Choomee, Nunghathai Sawasdee, Chalermchai Somboonpatarakun, Thaweesak Chieochansin, Sanya Sukpanichnant, Mutita Junking, Seiji Okada, Pa-Thai Yenchitsomanus, CD138-targeted bispecific protein engager-armed T cells exhibit potent and selective cytotoxicity against multiple myeloma cells, International Immunopharmacology, Volume 174, 2026, 116295, ISSN 1567-5769, https://doi.org/10.1016/j.intimp.2026.116295. April 1, 2026. 

Overview

CD138-targeted bispecific protein engager-armed T cells (BATs) demonstrated potent antitumor activity, achieving nearly 90% lysis of CD138-positive multiple myeloma cells in preclinical testing. The approach also showed a favorable safety profile, with strong cytolytic activation and low pro-inflammatory cytokine release, supporting its potential as an improved immunotherapy strategy.

"Effectiveness of linvoseltamab versus real-world standard-of-care in triple-class-exposed relapsed/refractory multiple myeloma in the United States"

Source

Kumar, S., Weisel, K.C., Spin, P. et al. Effectiveness of linvoseltamab versus real-world standard-of-care in triple-class-exposed relapsed/refractory multiple myeloma in the United States. Blood Cancer J. (2026). https://doi.org/10.1038/s41408-026-01470-6  April 1, 2026. 

Overview

LINKER-MM1 evaluated the BCMA×CD3 bispecific antibody linvoseltamab in heavily pretreated relapsed/refractory multiple myeloma patients, comparing outcomes against real-world standard-of-care using adjusted external control cohorts. Linvoseltamab showed significantly higher response rates and improved progression-free survival, time to next treatment, and overall survival versus standard therapies in triple-class exposed or refractory patients

"Social determinants of health associated with multiple myeloma incidence and survival among a low-income cohort in the Southeastern U.S. Hematology"

Source

Junkins, A., Wen, W., Lipworth, L., Han, X., Munro, H., Mumma, M. T., … Sudenga, S. (2026). Social determinants of health associated with multiple myeloma incidence and survival among a low-income cohort in the Southeastern U.S. Hematology, 31(1). https://doi.org/10.1080/16078454.2026.2653275  April 1, 2026.  

Overview

Living in socioeconomically deprived neighborhoods was associated with a more than twofold increased risk of multiple myeloma in the Southern Community Cohort Study, while residential racial segregation and population density also influenced incidence and survival outcomes. These findings suggest that social determinants of health, including neighborhood deprivation and structural inequality, may play a significant role in multiple myeloma risk and mortality among low-income Black and White populations.

"Real-World Progression-Free Survival and Healthcare Resource Utilization Associated with Daratumumab Use in Transplant-Ineligible Multiple Myeloma Patients in Italy"

Source

Perrone V, Barilà G, Franceschini L, Mele G, Mazzoni S, Cappuccilli M, Andretta M, Bacca M, Bartolini F, Barbieri A, Blasi A, Chinellato A, Dell'Orco S, Ferrante F, Lombardi R, Mancini D, Pagliaro R, Paciello A, Pastorello M, Procacci C, Ricciardulli D, Ubertazzo L, Valpondi P, Zucchi A, Degli Esposti L. Real-World Progression-Free Survival and Healthcare Resource Utilization Associated with Daratumumab Use in Transplant-Ineligible Multiple Myeloma Patients in Italy. Clinicoecon Outcomes Res. 2026 Apr 1;18:585246. doi: 10.2147/CEOR.S585246.   

Overview

Daratumumab-based regimens (DaraRd) were associated with significantly longer real-world progression-free survival compared with Rd alone in transplant-ineligible multiple myeloma patients across first- and second-line settings in an Italian real-world analysis. In first-line treatment, DaraRd also reduced hospitalization costs, highlighting both clinical and economic advantages in routine practice.

"Single-cell technologies in deciphering drug resistance of multiple myeloma: mechanistic insights and clinical translation prospects"

Source

Wu, J., Dong, H., Xu, X., & Wang, M. (2026). Single-cell technologies in deciphering drug resistance of multiple myeloma: mechanistic insights and clinical translation prospects. Leukemia & Lymphoma, 1–16. https://doi.org/10.1080/10428194.2026.2649879  April 1, 2026.    

Overview

Single-cell multi-omics research in multiple myeloma reveals that drug resistance and relapse are driven by both pre-existing resistant subclones and non-genetic adaptations, along with microenvironmental changes such as immune exhaustion and stromal remodeling. The findings emphasize the need for rigorous analytical methods and translational strategies to identify actionable targets and improve precision oncology approaches.

"Serum cholesterol levels demonstrate dynamic changes following autologous hematopoietic stem cell transplantation in patients with multiple myeloma"

Source

Yuan Chen, Shan Gao, Xin Zhao, Weikai Hu, Li Bao, Serum cholesterol levels demonstrate dynamic changes following autologous hematopoietic stem cell transplantation in patients with multiple myeloma, Experimental Hematology, 2026, 105427, ISSN 0301-472X, https://doi.org/10.1016/j.exphem.2026.105427.  April 1, 2026.    

Overview

Is blood cholesterol a gauge for myeloma relapse? A landmark study shows that with remission, cholesterol levels promptly rise, only to markedly drop upon the cancer's recurrence—unveiling a straightforward new approach to disease tracking.

"Promoter hypomethylation drives ABCB1-mediated carfilzomib resistance in multiple myeloma"

Source

Han, S., Haertle, L., Munawar, U. et al. Promoter hypomethylation drives ABCB1-mediated carfilzomib resistance in multiple myeloma. Clin Epigenet (2026). https://doi.org/10.1186/s13148-026-02115-y  April 1, 2026.     

Overview

Carfilzomib resistance in multiple myeloma may be driven by changes in DNA methylation that increase the activity of the ABCB1 gene, which helps cancer cells pump out the drug. Multi-omics analysis of patient samples and lab models showed that lower methylation levels in the ABCB1 promoter were linked to higher gene expression and drug resistance. Further testing confirmed that reducing methylation increased ABCB1 activity. These findings suggest that targeting DNA methylation could help overcome treatment resistance.

"BCMA/CD19 dual-targeting CAR T cell therapy in older patients with newly diagnosed multiple myeloma: a phase I study"

Source

Jin Liu, Xiaoqiang Fan, Liying Peng, Jia Liu, Haiyan He, Wanting Qiang, Lina Jin, Lang Shi, Jing Lu, Pei Guo, Nina Shah, Qi Zhang, Lianjun Shen, Juan Du; BCMA/CD19 dual-targeting CAR T cell therapy in older patients with newly diagnosed multiple myeloma: a phase I study. Blood Adv 2026; bloodadvances.2025019036. doi: https://doi.org/10.1182/bloodadvances.2025019036  April 2, 2026.       

Overview

AZD0120, a dual-targeting CAR T-cell therapy against BCMA and CD19, showed strong early results as a first-line treatment in older multiple myeloma patients aged 70 and above. In a small phase 1 trial, all patients achieved deep responses with no detectable disease, while side effects were manageable and mostly mild, including low-grade cytokine release syndrome. These findings suggest AZD0120 may be a promising frontline option, even for frail older adults.

"Identification of ceRNA Regulatory Networks Driven by the lncRNA NEAT1 in Multiple Myeloma"

Source

D.Ronchetti, V.Traini, I.Silvestris, et al., “Identification of ceRNA Regulatory Networks Driven by the lncRNA NEAT1 in Multiple Myeloma,” Journal of Cellular and Molecular Medicine30, no. 7 (2026): e71123, https://doi.org/10.1111/jcmm.71123.  April 2, 2026.      

Overview

The lncRNA NEAT1 is highly active in multiple myeloma and may help drive cancer growth by controlling a network of genes and microRNAs. Researchers identified a large NEAT1-related network that affects key processes like the cell cycle, which controls how cells grow and divide. Results from patient data and lab models showed that when NEAT1 levels drop, many related genes also decrease. These findings suggest NEAT1 plays an important role in myeloma progression and could be a potential treatment target

"Development and Preclinical Evaluation of a Selinexor-Derived Radiotracer [68Ga]Ga-NOTA-Selinexor for Imaging XPO1 Expression in Multiple Myeloma"

Source

Zhong X, Yan J, Su C, Xu W, Wang X, Pan D, Xu Y, Wang L, Chen C, Yang M. Development and Preclinical Evaluation of a Selinexor-Derived Radiotracer [68Ga]Ga-NOTA-Selinexor for Imaging XPO1 Expression in Multiple Myeloma. Mol Pharm. 2026 Apr 2. doi: 10.1021/acs.molpharmaceut.5c01792. Epub ahead of print.       

Overview

Researchers developed a new imaging agent based on selinexor that allows clearer PET scans of XPO1 expression in multiple myeloma. The updated tracer showed better stability, improved tumor visibility, and higher contrast compared to earlier versions in preclinical models. These results suggest it could help doctors more accurately diagnose disease and monitor treatment response.

"Phenotypic evolution of circulating plasma cells from early precursor stages to multiple myeloma"

Source

Pietzsch M, Beer SA, Kimmich LM, Windsor C, Gekeler S, Besemer B, Stanger AMP. Phenotypic evolution of circulating plasma cells from early precursor stages to multiple myeloma. Haematologica; https://doi.org/10.3324/haematol.2025.300105 [Early view].  April 2, 2026.       

Overview

Circulating tumor plasma cells (CTPCs) show important changes as multiple myeloma develops and progresses, making them useful for tracking disease and predicting outcomes. Advanced flow cytometry revealed that CTPCs gain and lose specific surface markers as the disease advances and after treatment, including signs of immune exhaustion. Differences between blood and bone marrow cells were also observed. These findings support CTPCs as a valuable, less invasive tool for monitoring multiple myeloma.

"Therapeutic inhibition of myeloperoxidase with AZD5904 attenuates disease progression in mouse models of early-stage and relapsed multiple myeloma"

Source

Williams CM, Noll JE, Harnas D, Parkinson HB, Hewett DR, Zannettino AC, Vandyke K, Cox TR, Panagopoulos V. Therapeutic inhibition of myeloperoxidase with AZD5904 attenuates disease progression in mouse models of early-stage and relapsed multiple myeloma. Haematologica; https://doi.org/10.3324/haematol.2025.300383 [Early view].  April 2, 2026.     

Overview

AZD5904, an oral drug that blocks myeloperoxidase (MPO), reduced tumor growth when used early in multiple myeloma and helped restore immune cell activity in preclinical models. While it did not improve results when combined with initial treatment, using AZD5904 after standard therapy delayed disease relapse. These findings suggest it may be useful as a maintenance treatment to extend remission.

"Anti–B-cell Maturation Antigen Chimeric Antigen Receptor T-cell Therapy bb21217 for Relapsed and Refractory Multiple Myeloma: Results from the Phase I CRB-402 Study"

Source

Melissa Alsina, Nina Shah, Sundar Jagannath, Jonathan L. Kaufman, David Siegel, Nikhil C. Munshi, Jacalyn Rosenblatt, Yi Lin, Andrzej J. Jakubowiak, Benjamin A. Derman, Aojun Li, Pingping Mao, Maeva Fincker, Ashish Yeri, Nathan Martin, Timothy B. Campbell, Olivia Finney, Anna Truppel-Hartmann, Fabio Petrocca, Jesus G. Berdeja, Noopur Raje; Anti–B-cell Maturation Antigen Chimeric Antigen Receptor T-cell Therapy bb21217 for Relapsed and Refractory Multiple Myeloma: Results from the Phase I CRB-402 Study. Cancer Immunol Res 1 April 2026; 14 (4): 528–542. https://doi.org/10.1158/2326-6066.CIR-24-0527  April 2, 2026.    

Overview

bb21217, a BCMA-targeted CAR T-cell therapy designed to enrich memory-like T cells, showed a 69% response rate and durable responses in patients with relapsed or refractory multiple myeloma. The study found that T cells with a memory-like profile expanded better and were linked to longer-lasting responses, especially when treatment was given earlier in the disease course. Safety results were consistent with other CAR T therapies, with no new concerns identified.

"Specialist Palliative Care and the Use of Healthcare Services Among Patients With Multiple Myeloma: A Nationwide Cohort Study"

Source

MA.Holopainen, H.-R.Lehto, T.Kuittinen, et al., “Specialist Palliative Care and the Use of Healthcare Services Among Patients With Multiple Myeloma: A Nationwide Cohort Study,” European Journal of Haematology (2026): 1–8, https://doi.org/10.1111/ejh.70184.  April 2, 2026.     

Overview

Access to specialist palliative care (SPC) was limited and often occurred late for patients with multiple myeloma, despite high healthcare use near the end of life. Patients who received SPC had fewer emergency visits, fewer hospital stays, and were less likely to die in the hospital. These findings suggest that earlier access to palliative care may improve end-of-life care and reduce intensive medical use.

"Microenvironmentally-derived Fatty Acid Binding Proteins 4 & 5 are Novel Therapeutic Vulnerabilities in Multiple Myeloma"

Source

Haylee Duval, Katherine Knox, Heather Fairfield, Ryan C. Chai, Alexander P. Corr, Ya-Wei Qiang, Kaitlyn Belknap, Kehinde Abayomi, Allyson Schimelman, Brian Nestor, Michelle Karam, Edward Jachimowicz, Patrizia J. Stohn, Xiangnan Guan, Matthew D. Lynes, Habib Hamidi, Peter I. Croucher, Sergey Ryzhov, Michaela R. Reagan, Microenvironmentally-derived Fatty Acid Binding Proteins 4 & 5 are Novel Therapeutic Vulnerabilities in Multiple Myeloma, Blood Neoplasia, 2026, 100229, ISSN 2950-3280, https://doi.org/10.1016/j.bneo.2026.100229. April 2, 2026   

Overview

Microenvironment-derived fatty acid binding proteins (FABP4 and FABP5) were studied for their role in multiple myeloma progression using mouse models, single-cell data, and patient datasets. Results showed that removing these proteins reduced tumor growth, improved survival, and lessened disease effects even in high-fat diet conditions. Lower FABP5 levels were also linked to better survival in patients, suggesting reduced immune suppression. These findings indicate that targeting FABP4/5 may help slow multiple myeloma through both tumor and immune system effects.

"IL-6-driven POU2AF1 and ELL2 are key regulators of multiple myeloma-distinct transcriptional and splicing programs"

Source

Yasuyo Ohguchi, Masahiko Ajiro, Daisuke Ogiya, Takeshi Masuda, Yawara Kawano, Shingo Usuki, Tomoaki Koga, Shinjiro Hino, Takeshi Harada, Satoru Takahashi, Seiji Okada, Jun-ichirou Yasunaga, Goro Sashida, Sumio Ohtsuki, Mitsuyoshi Nakao, Takashi Minami, Akihide Yoshimi, Hiroto Ohguchi; IL-6-driven POU2AF1 and ELL2 are key regulators of multiple myeloma-distinct transcriptional and splicing programs. Blood Adv 2026; bloodadvances.2025018710. doi: https://doi.org/10.1182/bloodadvances.2025018710  April 2, 2026. 

Overview

Multiple myeloma growth is supported by IL-6 signaling in the bone marrow, which activates key B cell factors (POU2AF1 and ELL2) that control both gene activity and RNA splicing. These factors help create a myeloma-specific genetic program that promotes tumor cell survival and can be blocked to suppress disease growth in lab and animal models. The study also showed that targeting POU2AF1 with antisense therapy reduced myeloma cell growth even in supportive bone marrow conditions. These findings suggest IL-6–driven transcription and splicing machinery may be a promising therapeutic target in multiple myeloma.

"Genomic mechanisms of resistance to venetoclax in multiple myeloma with t(11;14)(CCND1;IGH)."

Source

Marcella Kaddoura, J. Erin Wiedmeier-Nutor, Vikas A. Gupta, Tomas Jelinek, Bachisio Ziccheddu, Suganti Shivaram, Hongwei Tang, Rebecca W. Owens, Tereza Sevcikova, Rodrigo Fonseca, Michael Durante, Benjamin Diamond, Logan Zhao, Yuan X. Zhu, Chang-Xin Shi, Shannon M. Matulis, Constantine S. Mitsiades, Ola Landgren, Saad Usmani, Roman Hajek, Marta Chesi, P. Leif Bergsagel, Esteban Braggio, Lawrence H. Boise, Rafael Fonseca, Shaji Kumar, Francesco Maura, Linda B. Baughn; Genomic mechanisms of resistance to venetoclax in multiple myeloma with t(11;14)(CCND1;IGH). Blood 2026; 147 (14): 1598–1610. doi: https://doi.org/10.1182/blood.2025029996  April 2, 2026. 

Overview

In t(11;14) multiple myeloma treated with venetoclax, researchers used genomic sequencing to understand why some patients respond well while others relapse quickly. They found that RAS pathway mutations and certain high-risk genetic changes were linked to shorter response duration and treatment resistance. Over time, resistant disease often showed additional alterations in BCL2/MCL1 pathways and tumor suppressor genes. These results suggest that detailed genetic profiling can help predict and explain venetoclax resistance in this myeloma subtype

"Belantamab mafodotin, lenalidomide, and dexamethasone for intermediate-fit and frail patients with newly diagnosed myeloma"

Source

Evangelos Terpos, Maria Gavriatopoulou, Ioannis Ntanasis-Stathopoulos, Panagiotis Malandrakis, Despina Fotiou, Nikolaos Kanellias, Magdalini Migkou, Foteini Theodorakakou, Vasiliki Spiliopoulou, Eirini Solia, Evangelos Eleutherakis-Papaiakovou, Giorgos Psarros, Efstathios Kastritis, Meletios A. Dimopoulos; Belantamab mafodotin, lenalidomide, and dexamethasone for intermediate-fit and frail patients with newly diagnosed myeloma. Blood 2026; 147 (14): 1574–1583. doi: https://doi.org/10.1182/blood.2025031629  April 2, 2026.   

Overview

Belantamab mafodotin combined with lenalidomide and dexamethasone showed very high response rates in newly diagnosed multiple myeloma patients who were unfit for transplant, with most patients achieving disease control and long progression-free survival not yet reached. Eye-related side effects were common but generally manageable, and did not significantly affect quality of life or daily activities. The study also suggested that hematologist-led monitoring may safely guide treatment dosing without requiring frequent ophthalmology assessments. These results support further testing of this combination in larger phase 3 trials.

"Lenalidomide Plus Dexamethasone as FIRST-Line Therapy in Transplant-Ineligible Patients With Multiple Myeloma: Final Results of the Prospective, Non-Interventional Study FIRST-NIS and Comparison With the FIRST Pivotal Phase III Clinical Trial"

Source

H.Nückel, T.Behlendorf, H.Schulz, et al., “Lenalidomide Plus Dexamethasone as FIRST-Line Therapy in Transplant-Ineligible Patients With Multiple Myeloma: Final Results of the Prospective, Non-Interventional Study FIRST-NIS and Comparison With the FIRST Pivotal Phase III Clinical Trial,” Cancer Medicine15, no. 4 (2026): e71758, https://doi.org/10.1002/cam4.71758.  April 2, 2026.   

Overview

Lenalidomide plus low-dose dexamethasone (Rd) was evaluated in a real-world German study of transplant-ineligible newly diagnosed multiple myeloma patients, with a median age of nearly 78 years. The treatment showed a median progression-free survival of 22.9 months and overall survival of 58.1 months, along with stable quality of life and no new safety concerns. Younger and less frail patients had better outcomes, and Rd was also effective in those with kidney impairment. Overall, real-world results closely matched those seen in clinical trials, confirming Rd as a standard frontline option.

"The Role of Bispecific Antibodies in Relapsed/Refractory Multiple Myeloma With Renal Impairment: A Systematic Review"

Source

I.Ntanasis-Stathopoulos, S.Manganas, C.Filippatos, et al., “The Role of Bispecific Antibodies in Relapsed/Refractory Multiple Myeloma With Renal Impairment: A Systematic Review,” American Journal of Hematology (2026): 1–10, https://doi.org/10.1002/ajh.70312.  April 2, 2026.    

Overview

Bispecific antibodies showed similar effectiveness in relapsed or refractory multiple myeloma patients with and without kidney impairment, based on a review of clinical trials and real-world studies. Survival outcomes and response rates were comparable, and most side effects were similar between groups, although low platelet counts were more common in patients with kidney issues. These findings suggest bispecific antibodies are a safe and effective option even for patients with reduced kidney function.

"Anti-CD38-based quadruplet versus triplet induction regimens in transplant-ineligible newly diagnosed multiple myeloma: a systematic review and meta-analysis"

Source

Lau, G., Chandra, M.B., Fero, H. et al. Anti-CD38-based quadruplet versus triplet induction regimens in transplant-ineligible newly diagnosed multiple myeloma: a systematic review and meta-analysis. Int J Hematol (2026). https://doi.org/10.1007/s12185-026-04195-1  April 2, 2026.   

Overview

Anti-CD38–based quadruplet regimens were compared with triplet regimens in transplant-ineligible newly diagnosed multiple myeloma patients using data from multiple clinical trials. Quadruplet therapies improved progression-free survival, overall survival, and rates of deep response, including minimal residual disease negativity. While side effects and infection rates were slightly higher, they were generally manageable. These findings support quadruplet regimens as a more effective treatment option for appropriate patients.

"Temporal trends in second primary malignancies among long-term survivors of multiple myeloma across treatment eras: a population-based analysis of the SEER database"

Source

Lu, L., Lin, S., Chen, Y., & Huang, Y. (2026). Temporal trends in second primary malignancies among long-term survivors of multiple myeloma across treatment eras: a population-based analysis of the SEER database. Hematology, 31(1). https://doi.org/10.1080/16078454.2026.2653404  April 3, 2026.  

Overview

The risk of second primary cancers in long-term multiple myeloma survivors has decreased over time, especially with the use of newer treatments. Rates dropped from over 11% in earlier treatment eras to about 2.5% in the most recent period. Common secondary cancers included prostate, lung, and breast cancer, with some blood cancers also observed. These findings suggest that modern therapies may be safer over the long term, though more follow-up is needed.

"A randomized comparison of etoposide and cyclophosphamide for stem cell mobilization in newly diagnosed multiple myeloma"

Source

Sun, Y., Li, J., Dong, Y. et al. A randomized comparison of etoposide and cyclophosphamide for stem cell mobilization in newly diagnosed multiple myeloma. Sci Rep (2026). https://doi.org/10.1038/s41598-026-46787-1  April 2, 2026.  

Overview

High-dose etoposide was compared with cyclophosphamide for stem cell mobilization before transplant in newly diagnosed multiple myeloma patients. Etoposide led to higher stem cell collection success, required fewer procedures, and caused fewer side effects like nausea. More patients reached target stem cell levels with etoposide than with cyclophosphamide. These results suggest etoposide may be a more effective and safer option for stem cell mobilization.

"A novel small-molecule inhibitor of IRF4 selectively suppresses multiple myeloma"

Source

Lin Zhang, Xin Ding, Min Wu, Jing-Zan Zhang, Huang Chen, Mingyao Liu, Wen-Wei Qiu, Zhengfang Yi, A novel small-molecule inhibitor of IRF4 selectively suppresses multiple myeloma, Genes & Diseases, 2026, 102176, ISSN 2352-3042, https://doi.org/10.1016/j.gendis.2026.102176. April 3, 2026.   

Overview

Researchers identified G1126 as a new small-molecule drug that targets IRF4, a key protein that drives multiple myeloma growth and treatment resistance. In lab and animal models, G1126 slowed tumor growth, reduced resistant cancer cells, and improved response to chemotherapy without harming normal stem cells. The drug works by lowering the activity of several genes linked to cancer growth. These findings suggest targeting IRF4 could be a promising new treatment strategy for multiple myeloma.

"Comparative Effectiveness of Pomalidomide-Based Regimens in Relapsed/Refractory Multiple Myeloma: A Multicenter Real-World Analysis in China"

Source

Gao, S., Zhuang, J., Liu, A., Wang, D., Wang, W., Li, X., Wang, Z., Fang, M., Gong, M., Jia, Z., Wu, S., Xu, Z., Wang, G., & Bao, L. (2026). Comparative Effectiveness of Pomalidomide-Based Regimens in Relapsed/Refractory Multiple Myeloma: A Multicenter Real-World Analysis in China. Cancers, 18(7), 1160. https://doi.org/10.3390/cancers18071160  April 2, 2026.    

Overview

Pomalidomide-based treatments were compared in patients with relapsed or refractory multiple myeloma, showing that regimens with daratumumab (DPD) had the highest response rates. Progression-free survival was similar across treatment groups, though outcomes were influenced by disease stage and prior treatments. Side effects were mostly blood-related and manageable, with no treatment-related deaths. These findings help guide treatment choices in real-world settings.

"Daratumumab, lenalidomide, and dexamethasone versus daratumumab, bortezomib, and dexamethasone in relapsed and refractory multiple myeloma: A real-world propensity score-matched study"

Source

Cheng-Hsien Lin, Po-Wei Liao, Chieh‐Lin Jerry Teng, Yu-Chen Su, Tsung-Chih Chen, Shun-Fa Yang, Bor-Sheng Ko, Daratumumab, lenalidomide, and dexamethasone versus daratumumab, bortezomib, and dexamethasone in relapsed and refractory multiple myeloma: A real-world propensity score-matched study, Journal of the Formosan Medical Association, 2026, ISSN 0929-6646, https://doi.org/10.1016/j.jfma.2026.03.120. April 3, 2026.    

Overview

Daratumumab combined with lenalidomide and dexamethasone (DRd) was compared with daratumumab plus bortezomib and dexamethasone (DVd) in relapsed or refractory multiple myeloma using real-world data. DRd showed longer time before needing a new treatment and better overall survival than DVd. Side effects differed slightly between groups but were generally manageable. These results suggest DRd may be the more effective option for many patients.

"Dynamics of BCMA expression in patients with relapsed/refractory multiple myeloma receiving BCMA-directed CAR-T therapy"

Source

Rana, M.S., Fernandez-Pol, S., Jensen, A. et al. Dynamics of BCMA expression in patients with relapsed/refractory multiple myeloma receiving BCMA-directed CAR-T therapy. Blood Cancer J. (2026). https://doi.org/10.1038/s41408-026-01474-2 April 4, 2026.     

Overview

BCMA expression levels were studied in patients receiving BCMA CAR T-cell therapy for multiple myeloma to understand how they change over time and affect outcomes. Higher BCMA levels measured by flow cytometry were linked to better and longer-lasting responses, while levels often decreased at relapse. Complete loss of BCMA was rare, but reduced expression was common after treatment. These findings may help guide how BCMA-targeted therapies are used over time.

"Treatment Discontinuation After Achieving MRD Negativity in Multiple Myeloma in the Pre-BCMA Era: A Prospective, Single-Centre Study"

Source

K.Sato, K.Suzuki, S.Sugita, et al. “Treatment Discontinuation After Achieving MRD Negativity in Multiple Myeloma in the Pre-BCMA Era: A Prospective, Single-Centre Study.” eJHaem7, no. 2 (2026): e70281. https://doi.org/10.1002/jha2.70281  April 6, 2026.      

Overview

In this study, stopping treatment after achieving minimal residual disease (MRD) negativity was feasible for some multiple myeloma patients, with about two-thirds remaining treatment-free at 3 years. Over half of patients maintained MRD negativity after two years of follow-up. Outcomes were better in patients without high-risk genetic features and those with signs of normal bone marrow recovery. These findings suggest that carefully selected patients may safely pause therapy with close monitoring.

"Resistance to BCMA-Directed CAR T-Cell Therapy in Multiple Myeloma: Biology, Clinical Patterns, and Strategies to Overcome Treatment Failure"

Source

Mohammad Ahsen Soomro, Mohamed Ahmed, Al Ola Abdallah, Nausheen Ahmed, Jeries Kort, Resistance to BCMA-Directed CAR T-Cell Therapy in Multiple Myeloma: Biology, Clinical Patterns, and Strategies to Overcome Treatment Failure, Clinical Lymphoma Myeloma and Leukemia, 2026, ISSN 2152-2650, https://doi.org/10.1016/j.clml.2026.04.004. April 6, 2026.     

Overview

BCMA-directed CAR T-cell therapy produces strong initial responses in advanced multiple myeloma, but most patients eventually relapse due to several resistance mechanisms. These include loss or reduction of the BCMA target, changes in tumor cells, weakened CAR T-cell function, and an immune-suppressive bone marrow environment. Researchers are developing new strategies—such as dual-target CAR T cells and combination treatments—to overcome resistance. These approaches aim to improve long-term outcomes and create more personalized therapies.

"Isatuximab, carfilzomib, lenalidomide and dexamethasone in newly diagnosed multiple myeloma: a randomized phase 3 trial"

Source

Gay, F., Roeloffzen, W., Dimopoulos, M.A. et al. Isatuximab, carfilzomib, lenalidomide and dexamethasone in newly diagnosed multiple myeloma: a randomized phase 3 trial. Nat Med (2026). https://doi.org/10.1038/s41591-026-04282-0  April 6, 2026.      

Overview

In transplant-eligible newly diagnosed multiple myeloma, the EMN24 IsKia trial compared two quadruplet induction and consolidation regimens: isatuximab-KRd versus KRd alone. Adding isatuximab led to higher rates of deep measurable residual disease negativity after treatment and more sustained responses, without increasing serious side effects. Early data suggest improved depth of response, although long-term survival outcomes are still pending. These results support isatuximab-KRd as a stronger option within frontline quadruplet therapy.

"Daratumumab in high-risk MGUS and low-risk smoldering myeloma: results of the Phase II D-PRISM study"

Source

Nadeem, O., Aranha, M.P., Redd, R.A. et al. Daratumumab in high-risk MGUS and low-risk smoldering myeloma: results of the Phase II D-PRISM study. Nat Commun (2026). https://doi.org/10.1038/s41467-026-71483-z April 8, 2026.     

Overview

Single-agent daratumumab was tested in early-stage plasma cell disorders to see if early treatment could prevent progression to multiple myeloma. The study showed modest deep response rates and an overall response in about half of patients, but many still experienced biochemical progression. Treatment was generally safe with mostly low rates of serious side effects. These results suggest daratumumab alone has limited benefit in earlier disease and highlight the need for better patient selection using genomic and immune markers.

"The Clinical Characteristics and Outcomes of Multiple Myeloma Patients With Oligo or Non–Secretory Relapse—A Retrospective Cohort Study"

Source

Vaxman, Iuliana, ItaiZamir, InbarCohen, et al. 2026. “The Clinical Characteristics and Outcomes of Multiple Myeloma Patients With Oligo or Non–Secretory Relapse—A Retrospective Cohort Study,” Hematological Oncology: e70192. https://doi.org/10.1002/hon.70192.  April 7, 2026.     

Overview

Oligo-secretory multiple myeloma, where disease markers are low or hard to measure, can develop during the course of standard secretory myeloma and makes monitoring more challenging. In a long-term study, about 17% of patients developed this form at relapse, and overall survival after relapse was similar to patients with standard measurable disease. However, patients who later converted back to secretory disease required new treatment sooner than those who remained oligo-secretory. These findings highlight the clinical challenges of tracking and managing this less measurable form of myeloma.

"Monoclonal gammopathy of undetermined significance in individuals exposed to pesticides: systematic review and meta-analysis"

Source

Redolfi Oliota, A., Fachi, M., Cunha Junior, A. & Rizzotto, M. (). Monoclonal gammopathy of undetermined significance in individuals exposed to pesticides: systematic review and meta-analysis. Reviews on Environmental Health. https://doi.org/10.1515/reveh-2025-0022  April 8, 2026.     

Overview

MGUS, a condition that can precede multiple myeloma, may be influenced by environmental and occupational exposures such as pesticides. A review of available studies found possible links between certain pesticides and higher MGUS occurrence in rural workers, although the evidence was limited and varied. MGUS was also shown to increase with age across studies. Overall, more research is needed to better understand how occupational exposures may contribute to MGUS risk.

"Dietary intake and the risk of monoclonal gammopathy of undetermined significance: results from the population-based iStopMM screening study"

Source

Hallsson, S., Gunnarsdottir, I., Thordardottir, M. et al. Dietary intake and the risk of monoclonal gammopathy of undetermined significance: results from the population-based iStopMM screening study. Blood Cancer J. (2026). https://doi.org/10.1038/s41408-026-01480-4  April 8, 2026.     

Overview

Diet was studied as a possible risk factor for monoclonal gammopathy of undetermined significance (MGUS), a precursor condition to multiple myeloma, using data from a large Icelandic screening study. Overall dietary patterns were not linked to MGUS risk, suggesting diet is unlikely to play a major role in its development. However, high dairy intake was associated with increased risk of a specific MGUS subtype (IgA MGUS). These findings indicate that diet is not a major driver of MGUS, though certain food groups may have subtype-specific effects.

"Teclistamab interference with anti-BCMA chimeric antigen receptor T-cell detection by flow cytometry: duration and clinical implications"

Source

Schadt, J., von Bonin, M., Oelschlägel, U. et al. Teclistamab interference with anti-BCMA chimeric antigen receptor T-cell detection by flow cytometry: duration and clinical implications. Leukemia (2026). https://doi.org/10.1038/s41375-026-02961-y April 8, 2026.   

Overview

This study describes a flow cytometry method used to detect BCMA-targeting CAR T cells in multiple myeloma patients who had recently received teclistamab before anti-BCMA CAR therapy. Blood samples were processed using a standardized two-tube staining approach with controls to accurately measure BCMA-positive T cells. Results were validated using both healthy donors and treated patient controls to ensure reliability. This method helps track CAR T-cell presence and activity in patients undergoing sequential immunotherapy.

"STAT3/STAT5 Mutations Predict Shorter Overall Survival in Patients with Plasma Cell Myeloma"

Source

M. T.Ye, Z.Zuo, S.Calin, Y.Yang, and M. J.You, “STAT3/STAT5 Mutations Predict Shorter Overall Survival in Patients with Plasma Cell Myeloma,” European Journal of Haematology (2026): 1–9, https://doi.org/10.1111/ejh.70174.  April 8, 2026.    

Overview

STAT3 and STAT5 mutations in multiple myeloma appear early in disease development and often drive the dominant cancer clone. Patients with these mutations had more aggressive disease features, including higher tumor markers, complex genetics, and shorter overall survival compared with those without the mutations. Many cases also had additional high-risk mutations such as KRAS/NRAS or TP53. These findings suggest STAT3/STAT5 mutations may be important markers of poor prognosis and potential treatment targets.

"Tunneling Nanotube-Mediated Filamin A Transport Mechanosensitively Programs Osteoclastogenesis in Myeloma Bone Disease/STAT5 Mutations Predict Shorter Overall Survival in Patients with Plasma Cell Myeloma"

Source

Jing Guo, Jingjing Wang, Ying Xie, Yixuan Wang, Ziyi Peng, Mengqi Wang, Hao Cheng, Tiantian Li, Linchuang Jia, Hongwei Xu, Danchen Su, Mu Qiao, Huanhuan Liu, Xinyang Li, Wenjing Li, Di Wu, Jianyong Huang, P. Leif Bergsagel, Feng Li, Zhigang Zhao, Zhiqiang Liu; Tunneling Nanotube-Mediated Filamin A Transport Mechanosensitively Programs Osteoclastogenesis in Myeloma Bone Disease. Blood 2026; blood.2025031627. doi: https://doi.org/10.1182/blood.2025031627  April 8, 2026. 

Overview

Multiple myeloma cells can directly communicate with osteoclast precursor cells through tunneling nanotubes, transferring the protein Filamin-A (FLNA). This transferred protein activates signaling pathways that strengthen osteoclast formation and increase bone breakdown. Blocking these nanotube connections reduced FLNA transfer and protected against bone loss in preclinical models. These findings suggest a new mechanism driving myeloma-related bone disease and a potential therapeutic target to reduce bone damage

"Phase 1/1b study of BCMA-targeting bispecific T-cell engager pavurutamab in relapsed/refractory multiple myeloma"

Source

Hans C Lee, Wouter J. Plattel, Simon J. Harrison, Douglas W Sborov, Suzanne Lentzsch, Andrew Spencer, Ruben Niesvizky, Suzanne Trudel, Peter Mollee, Ravi Vij, Monique C Minnema, Leo Rasche, Vijay V Upreti, Di Zhou, Qing Xia, Mihaela Talpes, Tobias Eggert, Prashant Kapoor, Sikander Ailawadhi; Phase 1/1b study of BCMA-targeting bispecific T-cell engager pavurutamab in relapsed/refractory multiple myeloma. Blood 2026; blood.2025032044. doi: https://doi.org/10.1182/blood.2025032044  April 8, 2026.  

Overview

Pavurutamab (AMG 701), a BCMA-targeting bispecific T-cell engager, was tested in patients with heavily pretreated relapsed or refractory multiple myeloma. The therapy showed meaningful response rates, with deeper and more durable responses at the recommended dose, although side effects like cytokine release syndrome and infections were common. Overall, most toxicities were manageable and no new safety concerns emerged at the optimal dose. These results support pavurutamab as a promising anti-BCMA immunotherapy option in advanced multiple myeloma.

"HAT-PCR is non-inferior to NGS when quantifying measurable residual disease for myeloma"

Source

Hughes, E., Blombery, P., Kannan, S., Khong, T., Spencer, A. and Morley, A. (2026), HAT-PCR is non-inferior to NGS when quantifying measurable residual disease for myeloma. Br J Haematol. https://doi.org/10.1111/bjh.70478  April 8, 2026.  

Overview

Measurable residual disease (MRD) testing in multiple myeloma is commonly done using next-generation sequencing (NGS), but researchers evaluated a modified PCR method called HAT-PCR for its accuracy and sensitivity. In a head-to-head comparison, HAT-PCR showed results highly consistent with NGS and was able to detect very low disease levels with similar sensitivity. It also offered advantages such as lower cost, faster turnaround, and simpler testing. These findings suggest HAT-PCR could be a practical alternative to NGS for MRD monitoring in myeloma.

"Biochemical bone biomarkers in plasma cell dyscrasias for the British Journal of Haematology"

Source

Nador G, Vijjhalwar R, Javaid MK, Edwards CM, Ramasamy K. Biochemical bone biomarkers in plasma cell dyscrasias for the British Journal of Haematology. Br J Haematol. 2026;00:1–15. https://doi.org/10.1111/bjh.70467  April 8, 2026.   

Overview

Multiple myeloma is a type of blood cancer that affects plasma cells in the bone marrow. One of the major problems it causes is damage to bones. This happens because the cancer disrupts the normal balance between cells that break down bone and cells that build it up. As a result, bones can become weaker and develop painful or dangerous “holes” called bone lesions.

Doctors are studying blood and urine tests called bone turnover markers to better understand this process. These markers give clues about how quickly bone is being broken down or rebuilt. They may help doctors detect bone damage earlier, track how the disease is changing over time, and see how well treatments are working.

Research shows that some of these markers tend to be higher when the disease is active or worsening, while others reflect how well bone-building cells are working. However, these tests are not yet used routinely in everyday care because results can vary from person to person and between laboratories.

Different myeloma treatments also affect bone health in different ways. Some therapies can help improve bone strength by reducing cancer activity and allowing bone-building to recover. Others, like bisphosphonates, are already used to protect bones and reduce fractures.

Overall, bone turnover markers are promising tools, but more research is needed before they become a standard part of myeloma care. For now, imaging scans and clinical evaluation remain the main ways doctors monitor bone disease.

"A PET/CT Cross-Modal Wavelet Fusion and Pseudo-Mask Guided Network With Frozen SAM Decoder for Multiple Myeloma Segmentation"

Source

J. Han et al., "A PET/CT Cross-Modal Wavelet Fusion and Pseudo-Mask Guided Network With Frozen SAM Decoder for Multiple Myeloma Segmentation," in IEEE Transactions on Biomedical Engineering, doi: 10.1109/TBME.2026.3681892.  April 8, 2026.   

Overview

Researchers have developed a lightweight AI model for automatically detecting and segmenting myeloma lesions on PET/CT scans. The model uses a wavelet-based approach to reconcile the different types of information each imaging modality provides — CT captures structural and anatomical detail, while PET captures metabolic activity — and combines them more precisely than prior methods. Tested on 161 myeloma patients plus an independent public dataset, it achieved Dice scores of 0.83 and 0.85, outperforming established tools including nnU-Net and MedSAM.

The model runs on roughly 10 million parameters, about 96% fewer than the full SAM architecture it partially borrows from, making it practical for routine clinical deployment. Better automated lesion segmentation matters for myeloma patients because accurate measurement of disease extent on PET/CT informs staging, treatment planning, and response assessment — tasks that currently require substantial manual effort from radiologists.

"Evaluation of vaccine-induced antibody responses against SARS-CoV-2 in multiple myeloma patients from the northeastern region of Mexico"

Source

Rosario Salazar-Riojas, Dalila M. Alvarado-Navarro, María L. Ruiz-de la Cruz, Lorena Nefertiti Castro-Fuentes, Karina E. Vazquez-Hernandez, David Gomez-Almaguer, Adrian G. Rosas-Taraco, Evaluation of vaccine-induced antibody responses against SARS-CoV-2 in multiple myeloma patients from the northeastern region of Mexico, Hematology, Transfusion and Cell Therapy, Volume 48, Issue 2, 2026, 106448, ISSN 2531-1379, https://doi.org/10.1016/j.htct.2026.106448. April 8, 2026.  

Overview

A small study from northeastern Mexico measured IgG antibody responses to COVID-19 vaccination in 33 myeloma patients alongside 28 healthy controls, using mRNA vaccines (Pfizer-BioNTech, Moderna) and the AstraZeneca adenovector vaccine. After a single dose, antibody levels against the spike protein's receptor-binding domain were comparable between myeloma patients and healthy controls — a notable finding given myeloma's well-documented impairment of humoral immunity. Patients who received three or more doses produced significantly higher anti-spike IgG levels than those who received only one.

Just over half of myeloma patients (51.5%) showed antibodies against the nucleocapsid protein, indicating prior subclinical COVID-19 infection, and these patients also had higher spike antibody levels — suggesting past infection compounds the vaccine response. Abnormal kappa/lambda light chain ratios, a common marker of active myeloma, did not blunt antibody responses in nucleocapsid-positive patients. The authors conclude that booster doses should be prioritized for myeloma patients, including those on immunosuppressive therapy

"Mechanism of uptake and toxicity of a BCMA antibody drug conjugate with a MMAF payload by nonantigen expressing cells"

Source

Newman, C., Taylor, C., Sohanpal, G. et al. Mechanism of uptake and toxicity of a BCMA antibody drug conjugate with a MMAF payload by nonantigen expressing cells. Cell Biol Toxicol (2026). https://doi.org/10.1007/s10565-026-10183-2  April 8, 2026. .  

Overview

Belantamab mafodotin, a BCMA-targeting antibody-drug conjugate approved for relapsed/refractory myeloma, causes corneal toxicity in a substantial proportion of patients, but the mechanism has not been well understood. This study examined how the drug enters and damages human corneal epithelial cells (HCEC) that do not express BCMA — meaning the drug's intended target is absent — alongside kidney proximal tubule cells as a comparison tissue. Drug uptake in both cell types was concentration- and time-dependent, and once inside, the toxic payload (cys-mcMMAF) was released, disrupting the microtubule network and triggering cell death. Corneal cells showed greater uptake and cytotoxicity than kidney cells.

The drug entered corneal cells primarily through macropinocytosis, a non-specific cellular engulfment process, rather than through BCMA-mediated internalization — a finding that explains why corneal toxicity occurs independently of the drug's anti-myeloma targeting. Blocking this uptake pathway with a macropinocytosis inhibitor reduced drug entry by roughly 23%. Notably, treating cells under conditions mimicking intravenous immunoglobulin (IVIG) therapy reduced drug uptake, protected cell nuclei, and cut apoptosis significantly, pointing to IVIG as a potential strategy to mitigate corneal side effects — though the authors note further research is needed to confirm this.

"Pathogenic and clinical implications of the two-way interplay between clonal hematopoiesis of indeterminate potential and multiple myeloma"

Source

Margherita Scopetti, Filippo Viviani, Emanuele Calvi, Juan Carlos Entizne, Francesca Lazzaroni, Matteo C. Da Vià, Marta Lionetti, Niccolò Bolli, Pathogenic and clinical implications of the two-way interplay between clonal hematopoiesis of indeterminate potential and multiple myeloma, Clinical Lymphoma Myeloma and Leukemia, 2026, ISSN 2152-2650, https://doi.org/10.1016/j.clml.2026.04.003. April 8, 2026.  

Overview

Clonal hematopoiesis of indeterminate potential (CHIP) — the age-related accumulation of somatic mutations in blood stem cells — is detectable in roughly 10–33% of myeloma patients at diagnosis, a proportion that rises with treatment exposure. Phylogenetic data confirm that CHIP and myeloma arise from separate cell populations with no shared founder mutations, so CHIP is not a direct precursor of the malignant plasma cell clone. Single-cell RNA sequencing shows that CHIP-positive myeloma patients have a more inflammatory and immunosuppressive bone marrow microenvironment, with dysfunctional T cells and monocytes, upregulated immune-evasion signals, and activated plasma cell survival pathways — though whether CHIP drives this inflammatory milieu or is selected by it remains unresolved.

The relationship runs in both directions. Alkylating agents, particularly high-dose melphalan, and immunomodulatory drugs such as lenalidomide selectively expand pre-existing CHIP clones, raising prevalence to roughly 40–54% in patients on maintenance or at progression. This therapy-driven clonal expansion contributes to treatment-related myeloid neoplasms in a subset of patients, seen in approximately 2% after autologous transplant and up to 5% following CAR-T therapy in heavily pretreated populations. CHIP also correlates with delayed hematologic recovery after transplant and CAR-T, higher rates of grade ≥2 cytokine release syndrome, and — in at least one cohort — a higher five-year incidence of cardiovascular events.

Despite these associations, CHIP has not consistently worsened survival in myeloma, and its clinical significance appears context-dependent. As patients live longer on more potent regimens and T-cell redirecting therapies move into earlier lines of treatment, the authors argue for prospective studies that track CHIP longitudinally alongside therapy exposure and outcomes — a prerequisite for determining whether routine CHIP screening, risk-adapted treatment selection, or closer toxicity monitoring is warranted.

"Prognostic Factors Influencing the Efficacy and Safety of Teclistamab and Elranatamab in Multiple Myeloma: A Multicenter Propensity-Weighted Analysis"

Source

Jeremie Zerbit et al. Prognostic Factors Influencing the Efficacy and Safety of Teclistamab and Elranatamab in Multiple Myeloma: A Multicenter Propensity-Weighted Analysis. JCO Oncol Adv 3, e2500077(2026). DOI:10.1200/OA-25-00077   

Overview

This ten-center retrospective study assessed real-world outcomes in 201 relapsed/refractory myeloma patients treated with BCMA-targeting bispecific antibodies — 148 receiving teclistamab and 53 elranatamab — compared against 162 propensity score-matched historical controls. Over a median follow-up of 13 months, median progression-free survival reached 17.9 months in the bispecific antibody group overall; teclistamab patients had not yet reached median PFS at the time of analysis, while elranatamab patients had a median PFS of 9.3 months. Twelve-month overall survival was 73.4% with teclistamab versus 53.9% in matched controls.

The efficacy gains came with a substantially higher infection burden. Grade ≥3 infections occurred at a rate of 98.2 per 100 patient-years in bispecific antibody recipients versus 27.1 per 100 patient-years in controls, predominantly bacterial and viral in origin, and ICU admissions were more frequent in the treated group. Cytokine release syndrome occurred in roughly half of patients, though severe cases (grade ≥3) were rare at 2%; neurotoxicity affected 8.5%, with 5.9% reaching grade ≥3. The infection rates observed here reinforce that infectious complications — not just disease progression — represent a primary management challenge with this drug class in routine clinical practice.

"Deciphering epigenetic crosstalk in multiple myeloma pathogenesis and treatment"

Source

Alipoor, S.D., Shrestha, M., Liu, A. et al. Deciphering epigenetic crosstalk in multiple myeloma pathogenesis and treatment. Clin Epigenet (2026). https://doi.org/10.1186/s13148-026-02109-w  April 9, 2026.    

Overview

Myeloma is driven not only by genetic mutations but by epigenetic alterations — heritable changes in gene activity that do not alter the DNA sequence itself. This review summarizes how three categories of epigenetic disruption contribute to myeloma development and drug resistance: abnormal DNA methylation, dysregulated histone-modifying enzymes, and long non-coding RNAs (lncRNAs). Aberrant methylation patterns silence tumor suppressor genes and disrupt signaling pathways including Wnt/β-catenin, JAK/STAT, and apoptotic cascades from early disease stages onward. Overactive histone modifiers — particularly the methyltransferases EZH2 and MMSET and the deacetylases HDAC4 and HDAC6 — remodel chromatin in ways that favor myeloma cell survival. Dysregulated lncRNAs such as MALAT1 and MIAT1 further destabilize the genome and blunt treatment response.

These mechanisms are relevant beyond biology because they are pharmacologically actionable. Agents targeting DNA methyltransferases, HDACs, and bromodomain proteins are under investigation as strategies to reverse epigenetic reprogramming and restore drug sensitivity. The review frames these targets in the context of the resistance mechanisms they drive, making the case that epigenetic therapies — used alongside or after standard myeloma regimens — may help address one of the disease's most persistent clinical problems.

"Obesity Accelerates Multiple Myeloma Progression in Certain Mouse Models and in Humans"

Source

Heather Fairfield, Catherine R. Marinac, Habib Hamidi, Katherine Knox, Brian Nestor, Constance Marques-Mourlet, Giovanni Diaz, Cheryl V. Wong, Ameet K. Mishra, Allyson Schimelman, Ya-Wei Qiang, Michelle Karam, Mariah Farrell, Edward Jachimowicz, J. Patrizia Stohn, Brenda M. Birmann, Peter Cornelius, Michaela R. Reagan; Obesity Accelerates Multiple Myeloma Progression in Certain Mouse Models and in Humans. Cancer Prev Res (Phila) 2026; https://doi.org/10.1158/1940-6207.CAPR-25-0213  April 9, 2026.   

Overview

Obesity is an established risk factor for myeloma, but the biological mechanisms linking excess adiposity to disease progression have been poorly characterized, in part because no reliable animal model existed to study them. This study tested three established mouse myeloma models under high-fat diet conditions and found that only one — the C57BL/6J 5TGM1 semisyngeneic model — reliably reproduced obesity-accelerated myeloma. In that model, obese mice showed higher tumor engraftment rates, elevated serum IgG levels, and stronger bioluminescent tumor signals than controls. The model supports noninvasive spatial and temporal tumor tracking, making it suitable for studying how obesity interacts with immune function and other factors to drive disease.

On the clinical side, analysis of CoMMpass patient data linked moderate and severe obesity at diagnosis to higher mortality, and identified gene expression and pathway differences in myeloma cells from obese versus normal-weight patients — suggesting obesity does not merely create a permissive environment for myeloma but may alter the tumor itself. Together, the mouse model and clinical findings support obesity as an active modifier of myeloma biology rather than a passive comorbidity, and provide a platform for testing prevention or intervention strategies targeting the obesity-myeloma axis.

"The genetic landscape of extramedullary plasmacytoma: a comparative analysis with extramedullary disease of multiple myeloma"

Source

Vogelsberg A, Salmerón-Villalobos J, Wilhelmi A-L, Otto F, Schneider A, Mankel B, Bag E, Colmenero A, Dettmer MS, Narbaitz M, Tzankov A, Salaverria I, Bonzheim I, Fend F. The genetic landscape of extramedullary plasmacytoma: a comparative analysis with extramedullary disease of multiple myeloma. Haematologica; https://doi.org/10.3324/haematol.2025.300201 [Early view].  April 9, 2026.    

Overview

Extramedullary plasmacytoma (EMP) — a localized plasma cell tumor arising outside the bone marrow without other features of myeloma — carries a generally favorable prognosis, but distinguishing it from extramedullary disease of myeloma (EMD), which behaves aggressively, can be diagnostically difficult. This study performed detailed molecular profiling of 24 EMP and 24 EMD cases using FISH, copy number analysis, and targeted sequencing to characterize the genetic differences between the two entities.

EMP shared some genetic features with myeloma — including IGH rearrangements, hyperdiploidy, and 1q21 gains — but was substantially less genomically complex than EMD. EMP cases averaged 4.3 copy number changes versus 19.3 in EMD, and carried fewer mutations (median 2 versus 3). EMP was enriched for TRAF3 mutations, present in 6 EMP cases and absent in EMD, while EMD more frequently carried mutations associated with advanced myeloma, including NRAS/KRAS, TP53, TENT5C, ARID1A, and ATM. The distinct mutational profiles of the two entities — particularly the presence of TRAF3 mutations in EMP and the absence of RAS pathway and DNA damage response mutations — may help resolve diagnostically ambiguous cases and potentially identify EMP patients at higher risk of progression to myeloma.

"Multiple myeloma patients treated with lenalidomide-based regimens frequently experience delayed peripheral blood stem cell collection: a controlled real-life study"

Source

Danilo De Novellis, Raffaele Fontana, Michela Rizzo, Angela Carobene, Denise Morini, Bianca Serio, Roberto Guariglia, Serena Luponio, Maddalena Langella, Francesco Verdesca, Angela Amendola, Michele Cimminiello, Maria Cristina Scamuffa, Sara Pasquino Pascale, Giuseppe Coppola, Ferdinando Annarumma, Valentina Giudice, Michele Pizzuti, Carmine Selleri, Multiple myeloma patients treated with lenalidomide-based regimens frequently experience delayed peripheral blood stem cell collection: a controlled real-life study, Transfusion and Apheresis Science, 2026, 104430, ISSN 1473-0502, https://doi.org/10.1016/j.transci.2026.104430. April 10, 2026. 

Overview

Autologous stem cell transplantation remains standard care for eligible myeloma patients, but collecting sufficient peripheral blood stem cells (PBSCs) beforehand is a prerequisite — and lenalidomide, now widely used in induction regimens, can impair that collection. This two-center retrospective study compared PBSC mobilization outcomes in lenalidomide-treated patients against a control cohort treated with thalidomide, a first-generation immunomodulatory drug not associated with the same mobilization difficulties.

Lenalidomide-treated patients required longer apheresis sessions, collected fewer CD34+ cells on day one, and needed plerixafor — a mobilization rescue agent — more frequently than thalidomide-treated controls. Cyclophosphamide use was lower in the lenalidomide group, and its absence correlated with reduced rates of prolonged apheresis. Despite these collection difficulties, post-transplant outcomes did not differ significantly between the two groups. The authors flag this as directly relevant to current practice: daratumumab-based quadruplet induction regimens, which typically include lenalidomide, are increasingly used as frontline therapy in transplant-eligible patients, meaning mobilization impairment may affect a growing proportion of candidates. The findings argue for more individualized PBSC collection strategies — including earlier plerixafor use — in this setting.

"Association of ciltacabtagene autoleucel with immune effector cell-associated enterocolitis: insights from a large national database"

Source

Frey, C., Etminan, M. & Cherniawsky, H. Association of ciltacabtagene autoleucel with immune effector cell-associated enterocolitis: insights from a large national database. Blood Cancer J. 16, 58 (2026). https://doi.org/10.1038/s41408-026-01503-0  April 10, 2026. 

Overview

This letter to the editor analyzes FDA Adverse Event Reporting System (FAERS) data on immune effector cell-associated enterocolitis (IEC-EC), a delayed gastrointestinal toxicity characterized by severe non-bloody diarrhea and gut inflammation occurring weeks to months after CAR-T cell therapy. Querying FAERS records through October 2025 across all six FDA-approved CAR-T products, the authors found 31 cases of immune-mediated enterocolitis associated exclusively with ciltacabtagene autoleucel (cilta-cel), with a reporting odds ratio of 83.65 — a strong signal absent for all other products, including idecabtagene vicleucel (ide-cel), which targets the same antigen, BCMA. The FDA has already issued a warning regarding IEC-EC risk with cilta-cel.

The mechanistic picture that emerges points to direct CAR-T cell infiltration of the gut mucosa — rather than systemic cytokine effects — producing a GVHD-like injury pattern with villous blunting and epithelial apoptosis. Why cilta-cel appears more frequently implicated than ide-cel despite shared BCMA targeting is not established, but the authors raise the possibility that cilta-cel's dual scFv binding domains and higher target-cell avidity may play a role. Current treatment relies primarily on corticosteroids, which produce improvement in roughly 40% of cases, with infliximab or vedolizumab used in refractory patients. The authors emphasize that FAERS data are hypothesis-generating rather than definitive, and call for prospective studies to identify predictive biomarkers, standardize grading criteria, and clarify whether preventive strategies used for other CAR-T toxicities might reduce IEC-EC risk.

"Use of High- and Medium-Cut-off Membrane Hemodialysis for Removal of Free Light Chains in Patients with Multiple Myeloma—A Single-Center Experience"

Source

Skerget, M., Trampuz, B. V., Starman, T., & Gubensek, J. (2026). Use of High- and Medium-Cut-off Membrane Hemodialysis for Removal of Free Light Chains in Patients with Multiple Myeloma—A Single-Center Experience. Journal of Clinical Medicine, 15(8), 2917. https://doi.org/10.3390/jcm15082917  April 10, 2026. 

Overview

Light-chain cast nephropathy — kidney injury caused by toxic free light chains (FLCs) produced by myeloma plasma cells — requires rapid FLC reduction to preserve renal function and improve survival. This single-center retrospective study from Ljubljana evaluated high- and medium-cut-off hemodialysis (HCO/MCO HD), specialized dialysis membranes capable of clearing large FLC molecules, in 29 newly diagnosed myeloma patients presenting with acute kidney injury. Both hemodialysis and anti-myeloma therapy were started on the day of diagnosis per institutional protocol.

Starting from a median FLC concentration of 9,630 mg/L at presentation, levels fell to 2,400 mg/L by day 7, 1,083 mg/L by day 14, and 370 mg/L by day 30 — after a median of only four dialysis sessions. MCO HD cleared kappa FLCs at rates comparable to HCO HD for the lambda isotype. At three months, 87% of patients achieved a hematologic response and 79% achieved a renal response. The most clinically meaningful finding was the survival difference tied to early FLC reduction: patients who achieved ≥70% FLC reduction by day 7 had a median overall survival of 82.5 months, compared to 23.2 months in those who did not meet that threshold. The results support combining HCO/MCO HD with immediate anti-myeloma therapy as an effective strategy for this presentation, and identify the 7-day FLC reduction benchmark as a practical early indicator of longer-term outcomes.

"Diagnosis and management of immune effector cell-associated enterocolitis (IEC-EC) following ciltacabtagene autoleucel"

Source

Kenneth JC Lim, Hee Eun Lee, Zongming Eric Chen, Adam Bledsoe, Ricardo D Parrondo, Saurabh Chhabra, Katharine Dooley, Andre De Menezes Silva Corraes, Morie A Gertz, Yi Lisa Hwa, Haily Stephens, Prashant Kapoor, Melinda SY Tan, Taxiarchis V. Kourelis, Rahma Warsame, Joselle Cook, Moritz Binder, P. Leif Bergsagel, Udit Yadav, Julia Erin Wiedmeier-Nutor, Susan Geyer, Sikander Ailawadhi, Rafael Fonseca, Shaji K Kumar, Navreet Chowla, Yi Lin; Diagnosis and management of immune effector cell-associated enterocolitis (IEC-EC) following ciltacabtagene autoleucel. Blood Adv 2026; bloodadvances.2025018853. doi: https://doi.org/10.1182/bloodadvances.2025018853  April 10, 2026. 

Overview

Among 229 consecutive myeloma patients who received cilta-cel at Mayo Clinic, 9 (3.9%) developed IEC-EC — presenting as grade 3 non-bloody, non-resolving diarrhea often severe enough to require prolonged total parenteral nutrition. Symptom onset occurred a median of 85 days after infusion (range 35–166 days), and gastrointestinal coinfections were present in the majority of cases. Duodenal biopsies most commonly showed a GVHD-like mucosal injury pattern; two cases showed histopathology resembling T-cell lymphoproliferative disorder. Independent risk factors for developing IEC-EC included high-risk myeloma by IMWG criteria, prolonged cytokine release syndrome, and preceding delayed neurotoxicity — suggesting IEC-EC may cluster with a broader pattern of severe immune toxicity in susceptible patients.

First-line treatment with corticosteroids, bile acid sequestrants, intravenous immunoglobulin, and antimicrobial therapy produced no durable responses. Biologic therapy fared better: vedolizumab induced durable responses in both patients who received it, and infliximab worked in one of three. Notably, none of the biologic responders had concurrent gastrointestinal coinfection, raising the possibility that coinfection blunts treatment response. The authors recommend early gastroenterology involvement with endoscopic evaluation including duodenal biopsy, and advocate moving to biologic therapy promptly after a short corticosteroid course fails rather than persisting with ineffective first-line agents.

"Breakthroughs of bispecific antibodies therapy in multiple myeloma: latest updates from 2025 ASH"

Source

Zhao, B., Bu, Q., Chen, AL. et al. Breakthroughs of bispecific antibodies therapy in multiple myeloma: latest updates from 2025 ASH. Biomark Res 14, 41 (2026). https://doi.org/10.1186/s40364-026-00912-4  April 10, 2026.  

Overview

Updated data presented at the 2025 ASH Annual Meeting across multiple bispecific antibody trials showed continued maturation of results in both relapsed/refractory and newly diagnosed myeloma. The most practice-defining readout came from the phase 3 MajesTEC-3 trial, where teclistamab plus daratumumab produced a 36-month PFS of 83.4% versus 29.7% for daratumumab-based standard of care in early relapsed disease, with MRD negativity rates of 58.4% versus 17.1%. In relapsed/refractory myeloma, dual bispecific therapy with talquetamab plus teclistamab (RedirecTT-1) showed an ORR of 92.3% in patients without extramedullary disease, though outcomes were substantially worse in extramedullary disease (36-month PFS 39.7% versus 70.5%), reinforcing that extramedullary disease remains a difficult-to-treat subset. Cevostamab (FcRH5-targeting) used as consolidation after BCMA-directed CAR-T achieved 93% MRD negativity at one year with 95% 12-month PFS and OS — an intriguing sequential strategy for sustaining remission after cellular therapy.

In newly diagnosed myeloma, frontline bispecific data are earlier but notable. Teclistamab plus daratumumab in transplant-ineligible patients produced a 100% ORR with 97% achieving VGPR or better, and 100% MRD negativity at six months in evaluable patients. Linvoseltamab as immunoconsolidation converted all 14 MRD-positive post-induction patients to MRD negativity. Across trials, infectious toxicity is the dominant safety concern — infection rates exceeded 90% in MajesTEC-3 and RedirecTT-1 — and the authors identify optimal treatment sequencing and long-term infection management as the field's most pressing unanswered questions.

"Functionally high-risk disease is associated with poor outcomes after late-line CAR T-cell therapy for multiple myeloma"

Source

Hashmi, H., Sebastian, T., Rajeeve, S. et al. Functionally high-risk disease is associated with poor outcomes after late-line CAR T-cell therapy for multiple myeloma. Blood Cancer J. (2026). https://doi.org/10.1038/s41408-026-01494-y April 12, 2026.  

Overview

Functionally high-risk myeloma (FHRMM), defined as progression within 24 months of frontline therapy, carries a poor prognosis, and data on CAR-T outcomes specifically in this population in later lines of treatment have been limited. This single-center study examined 208 patients who received CAR-T, of whom 117 (56%) had FHRMM and had received a median of 5 prior lines of therapy. FHRMM patients had higher rates of extramedullary disease and more frequent progression within 12 months of transplant compared to non-FHRMM patients.

Median PFS was 11 versus 13 months (p=0.15) and median OS was 34 versus 55 months (p=0.025) in FHRMM versus non-FHRMM patients, respectively. On multivariable analysis, active extramedullary disease and high disease burden at the time of CAR-T infusion drove the survival difference — not the FHRMM designation itself. The finding carries a practical implication: FHRMM patients who received CAR-T without active extramedullary disease or high burden fared better, suggesting that deploying CAR-T earlier in the treatment course — before disease evolves those features — may improve outcomes in this high-risk group.

"CAR-T therapy moving to first-line in multiple myeloma: latest updates from the 2025 ASH annual meeting"

Source

Geng, C., Chen, W. & Zhu, HH. CAR-T therapy moving to first-line in multiple myeloma: latest updates from the 2025 ASH annual meeting. J Hematol Oncol 19, 25 (2026). https://doi.org/10.1186/s13045-026-01793-8  April 13, 2026. 

Overview

ASH 2025 brought updated and early-phase data across a wide range of CAR-T strategies in myeloma, with the most mature results continuing to come from BCMA-targeted products. In relapsed/refractory disease, a KarMMa-3 subgroup analysis showed ide-cel produced an ORR of 81.6% versus 48.1% for standard of care in patients aged 70 and older, with median PFS of 18.9 versus 5.7 months. CARTITUDE-4 reported a 30-month PFS of 71.0% with cilta-cel versus 43.2% for standard of care in standard-risk cytogenetics patients, reaching 80.5% in the as-treated population. The phase 2 iMMagine-1 trial of anito-cel, a newer BCMA-targeted product, showed a 97% ORR with 93% MRD negativity in 117 relapsed/refractory patients. Early-phase dual-targeting strategies — pairing BCMA with GPRC5D, CD19, or TACI — consistently produced 80–100% ORRs in small cohorts, with several reporting universal MRD negativity by day 28. Allogeneic and in vivo CAR-T approaches remain in earliest-phase testing but showed initial signals of activity without treatment-related deaths or dose-limiting toxicities.

Frontline CAR-T data, while from smaller trials, produced the meeting's most striking response rates. Across NDMM studies, ORRs reached 100% in multiple cohorts, stringent complete response rates approached 89–94%, and 30-month PFS and OS rates ranged from 74–88% and 81–92%, respectively — including in patients with high-risk cytogenetics and extramedullary disease. A sequential CAR-T/transplant/CAR-T strategy in TP53-mutated patients achieved MRD-negative complete responses in all 14 patients, though two with biallelic TP53 inactivation relapsed within 16 months, a reminder that this subgroup remains particularly difficult to durably control.

"Circulating Tumor Cells in Multiple Myeloma: From Peripheral Clues to Central Insights"

Source

B.Podvin, B.Paiva, I. M.Ghobrial, and S.Manier, “Circulating Tumor Cells in Multiple Myeloma: From Peripheral Clues to Central Insights,” American Journal of Hematology (2026): 1–14, https://doi.org/10.1002/ajh.70326  April 13, 2026. 

Overview

Circulating tumor cells (CTCs) — malignant plasma cells that escape the bone marrow and enter the bloodstream — can now be detected across the full myeloma disease spectrum, from MGUS and smoldering myeloma through symptomatic disease and plasma cell leukemia. This review summarizes the biological significance, prognostic value, and clinical potential of CTC analysis in myeloma. High-sensitivity flow cytometry and next-generation single-cell sequencing have made accurate CTC enumeration and molecular profiling feasible, and even low CTC levels at diagnosis independently predict inferior survival. Proof-of-concept studies including MinimuMM-seq and SWIFT-seq demonstrated that genomic and transcriptomic profiling of CTCs can reproduce canonical myeloma mutations, map clonal heterogeneity, and track how the tumor evolves under treatment pressure.

The complementary role of CTCs alongside bone marrow MRD assessment is an area of growing interest. Persistent or reappearing CTCs after therapy — particularly in patients who are also MRD-positive in the bone marrow — may serve as an early signal of relapse, offering a less invasive and more dynamic window into disease status than repeat bone marrow biopsy. The authors frame CTC analysis as a tool with genuine clinical promise but note that standardization of detection methods and integration into routine workflows remain unresolved before it can move from research application to standard practice.

"Selection of anti-CD38 antibodies for flow cytometric detection of myeloma cells treated with daratumumab or isatuximab"

Source

Inoue, Y., Harada, T., Oda, A. et al. Selection of anti-CD38 antibodies for flow cytometric detection of myeloma cells treated with daratumumab or isatuximab. Int J Hematol (2026). https://doi.org/10.1007/s12185-026-04210-5  April 13, 2026. 

Overview

Accurate MRD assessment by flow cytometry in myeloma depends on reliably identifying malignant plasma cells, and CD38 is one of the primary surface markers used for this purpose. Both daratumumab and isatuximab target CD38, and their binding can interfere with the antibody clones used to detect CD38 during flow cytometric MRD testing — potentially masking residual disease. While daratumumab's interference with standard CD38 detection has been documented, isatuximab's effect has been less well characterized.

This study tested several CD38 detection antibody formats in myeloma cells exposed to each drug, then confirmed findings in primary bone marrow samples from treated patients. The results showed that the choice of detection antibody needs to be matched to the patient's treatment history: a VHH antibody (single-domain heavy-chain antibody from the JK36 clone) outperformed standard anti-CD38 antibodies in daratumumab-treated cells, while conventional anti-CD38 monoclonal antibodies performed better in isatuximab-treated cells. No single detection approach worked optimally across both drugs. The practical implication is that MRD laboratories need to account for which anti-CD38 therapy a patient has received when selecting flow cytometry reagents, as using the wrong detection antibody risks underestimating residual disease and producing falsely reassuring MRD results.

"The Value of Progression-Free Survival in the Perspective of Patients with Multiple Myeloma and Treating Physicians: Research Findings from the US, EU4, UK, Brazil, and Japan"

Source

Aaron S. Rosenberg, Thomas Chalopin, Alison Bulkley, Kyla Finlayson, Corey Neff, Oliver Will, Yu-Hsuan Shih, Laurie Eliason, Thomas S. Marshall, Zander Pittman, Marc DeCongelio, The Value of Progression-Free Survival in the Perspective of Patients with Multiple Myeloma and Treating Physicians: Research Findings from the US, EU4, UK, Brazil, and Japan, Clinical Lymphoma Myeloma and Leukemia, 2026, ISSN 2152-2650, https://doi.org/10.1016/j.clml.2026.03.018. April 13, 2026. 

Overview

Regulatory agencies in some countries do not recognize progression-free survival (PFS) as a patient-relevant endpoint when evaluating new myeloma treatments, preferring overall survival (OS) despite the practical difficulty of measuring OS in a disease where patients now live for many years and receive multiple subsequent therapies. This international cross-sectional study surveyed 237 myeloma patients and 267 treating physicians across the US, UK, Spain, France, Germany, Italy, Brazil, and Japan to assess how both groups weigh PFS relative to other treatment outcomes when making treatment decisions.

Both patients and physicians rated OS and PFS as important across all lines of therapy, with physicians placing particular weight on PFS when treating patients at relapse or in high-risk populations. Physicians also supported PFS as a valid basis for healthcare coverage and access decisions. The findings directly challenge the regulatory position that PFS lacks patient relevance in myeloma, and the authors argue the data support incorporating PFS into both treatment guidelines and regulatory approval frameworks — particularly as longer survival makes OS an increasingly impractical primary endpoint in clinical trials.

"Review of the first on-body injector (obi) for the subcutaneous delivery of an oncology drug: isatuximab in multiple myeloma"

Source

Ocio, E. M., Parmar, G., Mateos, M. V., Leleu, X., Buck, T. T., Tan, C. R., … Moreau, P. (2026). Review of the first on-body injector (obi) for the subcutaneous delivery of an oncology drug: isatuximab in multiple myeloma. Expert Opinion on Drug Delivery. https://doi.org/10.1080/17425247.2026.2659263 April 13, 2026. 

Overview

Isatuximab, an anti-CD38 monoclonal antibody currently approved for intravenous use in myeloma, is under investigation for subcutaneous delivery via an on-body injector (OBI) — a small wearable device with a retractable, hidden needle that administers the drug hands-free without requiring a clinician to hold a syringe throughout the injection. This review summarizes published data through 2025 on OBI use in oncology, with a focus on isatuximab, and covers clinical trial findings, workflow implications, and practical considerations for adoption.

The authors identify several potential advantages over both intravenous infusion and conventional subcutaneous injection. For patients, the hidden needle addresses needle phobia and the device reduces the physical experience of manual injection. For clinical staff, hands-free delivery reduces physical strain associated with administering viscous subcutaneous agents manually and shortens the time clinicians need to be directly engaged with the administration process. For infusion centers, shorter chair time per patient has workflow and capacity implications. The review frames the OBI not as an incremental packaging change but as a delivery format with potential to meaningfully affect how myeloma treatment is experienced by both patients and healthcare providers, though the authors note that ongoing trials will determine how these benefits translate in routine clinical settings.

"Icaritin Inhibits Malignant Progression and Enhances Ferroptosis and Bortezomib Sensitivity by Suppressing HSP90AA1 Expression in Multiple Myeloma"

Source

Shi, L., D.Lv, X.Wang, et al. 2026. “Icaritin Inhibits Malignant Progression and Enhances Ferroptosis and Bortezomib Sensitivity by Suppressing HSP90AA1 Expression in Multiple Myeloma.” Chemical Biology & Drug Design107, no. 4: e70284. https://doi.org/10.1111/cbdd.70284.  April 13, 2026. 

Overview

Bortezomib resistance is a common obstacle in myeloma treatment, and identifying agents that can restore sensitivity to it remains an active area of research. This preclinical study examined icaritin — a plant-derived compound with documented anti-tumor activity across several cancer types — for its effects on myeloma cell growth and bortezomib sensitivity. Using a combination of cell viability assays, flow cytometry, network pharmacology, and protein interaction studies, the investigators found that icaritin suppressed myeloma cell proliferation, induced ferroptosis (an iron-dependent form of programmed cell death distinct from apoptosis), and increased myeloma cell sensitivity to bortezomib both in cell culture and in animal models.

The mechanism centered on HSP90AA1, a heat shock protein that the study found promotes myeloma cell proliferation, suppresses ferroptosis, and blunts bortezomib sensitivity. Icaritin reduced HSP90AA1 protein levels by promoting its ubiquitination and subsequent degradation. Blocking HSP90AA1 recapitulated icaritin's effects, while its preservation attenuated them, supporting HSP90AA1 inhibition as the primary mechanism through which icaritin acts. The findings are entirely preclinical, but they identify HSP90AA1 as a potentially relevant resistance node in myeloma and icaritin as a candidate worth evaluating in further studies aimed at overcoming bortezomib resistance.

"Association of genetic ancestry with outcomes and toxicity of idecabtagene vicleucel in patients with relapsed/refractory multiple myeloma"

Source

Dillard, C.M., Lee, H., Kalariya, N. et al. Association of genetic ancestry with outcomes and toxicity of idecabtagene vicleucel in patients with relapsed/refractory multiple myeloma. Blood Cancer J. 16, 59 (2026). https://doi.org/10.1038/s41408-026-01489-9  April 13, 2026.  

Overview

This single-center retrospective study from MD Anderson examined outcomes with ide-cel in relapsed/refractory myeloma across racial, ethnic, and genetic ancestry groups — an underrepresented dimension in CAR-T trial data. The cohort included non-Hispanic White, non-Hispanic Black, and Hispanic/Latino patients who underwent apheresis between November 2018 and February 2023, treated either on clinical trial (KarMMa-2, KarMMa-3) or as standard of care. Beyond self-identified race and ethnicity, the study used germline genotyping to estimate continental genetic ancestry proportions — African, European, and Admixed American — allowing analysis independent of self-reported categories.

Efficacy outcomes (ORR, PFS, OS) and safety outcomes (CRS, ICANS, hematologic toxicities) were compared across groups, with multivariable analyses adjusting for cytogenetics, extramedullary disease, degree of prior treatment, and refractoriness. The methodology is notable for its use of genetic ancestry estimation alongside self-identified race and ethnicity, which allows the study to separate socioenvironmental from biological factors that may influence treatment outcomes — a distinction that self-reported categories alone cannot make. Results from this analysis were not included in the provided text, but the design addresses a meaningful gap given that Black and Hispanic patients have historically been underrepresented in myeloma CAR-T trials despite differing disease biology and baseline characteristics compared to non-Hispanic White patients.

"Exposure-response analyses for belantamab mafodotin in combination with bortezomib and dexamethasone in patients with relapsed/refractory multiple myeloma from DREAMM-6 Arm B and DREAMM-7"

Source

Papathanasiou, T., Chen, X., Carreno, F. et al. Exposure-response analyses for belantamab mafodotin in combination with bortezomib and dexamethasone in patients with relapsed/refractory multiple myeloma from DREAMM-6 Arm B and DREAMM-7. Br J Cancer (2026). https://doi.org/10.1038/s41416-026-03437-7  April 13, 2026. 

Overview

Belantamab mafodotin causes dose-dependent ocular toxicity, and selecting the right starting dose in the BVd regimen (belantamab mafodotin, bortezomib, dexamethasone) requires balancing response depth against eye-related side effects. This pharmacokinetic analysis used cycle 1 drug exposure data from the DREAMM-6 and DREAMM-7 studies to model exposure-efficacy and exposure-safety relationships across multiple doses and schedules.

Higher cycle 1 belantamab mafodotin exposure correlated with deeper responses and with abnormal ophthalmic exam findings, but not with clinically meaningful visual acuity worsening (to 20/50 or worse in both eyes) or grade ≥3 ocular adverse events. Across the exposure range studied, the probability of achieving VGPR or better exceeded the probability of serious ocular toxicity. Modeling showed that dropping the starting dose from 2.5 mg/kg to 1.9 mg/kg would reduce response rates without meaningfully reducing the risk of visual acuity worsening or grade ≥3 ocular adverse events — the outcomes most relevant to patients. The analysis supports 2.5 mg/kg as the appropriate starting dose for BVd, providing pharmacokinetic rationale for the dose used in DREAMM-7 and arguing against preemptive dose reduction as a strategy to mitigate ocular risk.

"Treatment patterns, effectiveness, and safety of daratumumab-based regimens in Chinese patients with multiple myeloma: longer follow-up of the real-world MMY4032 study"

Source

Yang, W., Wang, L., Wang, Y. et al. Treatment patterns, effectiveness, and safety of daratumumab-based regimens in Chinese patients with multiple myeloma: longer follow-up of the real-world MMY4032 study. Ann Hematol 105, 240 (2026). https://doi.org/10.1007/s00277-026-06972-8  April 13, 2026. 

Overview

This second interim analysis of the MMY4032 study reports real-world daratumumab outcomes in 212 Chinese myeloma patients with up to three prior lines of therapy, with a median follow-up of 16.2 months. Daratumumab was most commonly initiated in the second line, typically combined with a proteasome inhibitor and/or immunomodulatory drug. Among 189 response-evaluable patients, the ORR was 74.1%, with 55.6% achieving VGPR or better and 60% of tested patients reaching MRD negativity. Median PFS was 32.8 months and median OS had not been reached, with 12-month rates of 77.9% and 87.8% respectively. Adverse drug reactions and serious adverse events occurred in 20.3% and 15.6% of patients, with no new safety signals identified.

The most consistent finding across both interim analyses is that earlier daratumumab initiation produced deeper responses and better survival outcomes than later-line use — a pattern aligned with trial data from non-Chinese populations and supporting the use of daratumumab-based regimens in earlier lines of therapy. The study fills a meaningful gap given that large randomized daratumumab trials have had limited Chinese patient representation, and the results suggest efficacy and safety profiles are broadly consistent with those observed in global studies.

"Patterns of care in relapsed/refractory multiple myeloma in China: a real-world physician survey study"

Source

Wu, D., Murali, B., Clark, O., Luan, L., Hlavacek, P., Ashraf Chaudhary, M., … DiBonaventura, M. (2026). Patterns of care in relapsed/refractory multiple myeloma in China: a real-world physician survey study. Future Oncology, 1–7. https://doi.org/10.1080/14796694.2026.2656394 April 13, 2026. 

Overview

This analysis of the CancerMPact Treatment Architecture database draws on a 2024 survey of 120 Chinese physicians to characterize real-world regimen selection and treatment duration across second and later lines of myeloma therapy in China. The most striking finding is the degree of fragmentation: no single regimen accounted for more than 10% of patients at any treatment line. In the second line, two-thirds of patients received a bortezomib-based, daratumumab-based, or daratumumab-plus-bortezomib regimen, with carfilzomib/pomalidomide/dexamethasone (9.6%), daratumumab/bortezomib/dexamethasone (9.0%), and daratumumab/bortezomib/lenalidomide/dexamethasone (7.6%) the most common individual choices. Third-line patterns were similarly distributed, with carfilzomib-containing and daratumumab-containing combinations again predominating. CAR-T and other novel agents appeared more frequently in later lines.

The heterogeneity reflects both the absence of dominant evidence-based standards for relapsed/refractory myeloma in China and the practical constraints of drug availability and reimbursement that shape real-world prescribing differently from trial populations. Treatment durations of roughly 7–9 months across the most common regimens provide a benchmark for clinical planning, though the survey-based methodology and reliance on physician-reported data are limitations. The authors frame the findings as a case for developing clearer, locally validated guidelines for later-line myeloma management in China.

"An Italian Delphi consensus on the current and future burden and clinical management of lenalidomide-refractory multiple myeloma"

Source

Paolo Corradini, Pellegrino Musto, Carlotta Galeone, Paolo Mariani, Federica Resci, Michele Cavo, An Italian Delphi consensus on the current and future burden and clinical management of lenalidomide-refractory multiple myeloma, Leukemia Research, 2026, 108230, ISSN 0145-2126, https://doi.org/10.1016/j.leukres.2026.108230. April 13, 2026.  

Overview

Lenalidomide is now used in frontline myeloma regimens so routinely that the majority of patients entering second-line therapy are already refractory to it — a pattern that is reshaping how relapsed disease is managed. This modified Delphi study gathered consensus opinions from 12 Italian hematologists across two rounds between January and July 2024 to characterize the burden of lenalidomide-refractory myeloma and identify treatment priorities.

Panelists reached full consensus (100%) that the primary unmet need in this setting is approval and access to novel immunotherapies with new mechanisms of action, and agreed that more than 80% of Italian patients starting second-line therapy in 2026 will be lenalidomide-refractory. More than two-thirds supported using T-cell redirecting therapies — both CAR-T and bispecific antibodies — from the second line onward, rather than reserving them for later lines as currently practiced in most centers. Notably, no patient characteristics emerged that experts could use to guide treatment selection within lenalidomide-refractory subgroups, reflecting the absence of validated biomarkers or clinical features to personalize therapy in this population. The findings underscore a growing mismatch between the clinical need for effective second-line options in lenalidomide-refractory disease and the current access to the therapies most likely to address it.

"Clinical Scores to Predict Toxicities and Outcomes in Patients with Multiple Myeloma Undergoing Bispecific T-cell Engager Therapy"

Source

Jan H. Frenking, Christine Riedhammer, Thomas Hielscher, Christoph Schaefers, Lisa B. Leypoldt, Marie Harzer, David Sedloev, Valentine Landrin, Niklas Kehl, Mirco J. Friedrich, Xiang Zhou, Maximilian Steinhardt, Philipp Weis, Julia Mersi, Johannes Waldschmidt, Niels Weinhold, K. Martin Kortüm, Carsten Müller-Tidow, Hermann Einsele, Sandra Sauer, Katja Weisel, Tim Richardson, Raphael Teipel, Leo Rasche, Marc S. Raab; Clinical Scores to Predict Toxicities and Outcomes in Patients with Multiple Myeloma Undergoing Bispecific T-cell Engager Therapy. Blood Cancer Discov 2026; https://doi.org/10.1158/2643-3230.BCD-25-0062  April 14, 2026.   

Overview

Bispecific T-cell engagers have demonstrated substantial efficacy in relapsed/refractory myeloma, but serious infections, cytopenias, and treatment failure affect a meaningful proportion of patients. Risk scores originally developed for CAR-T therapy — including CAR-HEMATOTOX (HTX), EASIX, and modified EASIX — incorporate readily available clinical parameters to identify patients at higher risk for complications before treatment, but whether they perform similarly before bispecific antibody therapy had not been established.

This study evaluated all three scores in independent discovery (n=123) and validation (n=155) cohorts of patients treated with T-cell engagers. Patients with HTX ≥3 or modified EASIX above the median (>0.86) had significantly higher rates of prolonged hospitalization, antibiotic use, and fever during step-up dosing, along with more frequent cytopenias requiring intervention and higher infection burden. These patients also had lower response rates and shorter PFS and OS. The finding that scores derived from CAR-T data generalize to bispecific antibody recipients is clinically useful: both HTX and modified EASIX use parameters available before treatment starts, meaning they could inform decisions about step-up dosing schedules, prophylactic strategies, or patient selection without requiring additional testing.

"Adding Bortezomib and Bendamustine to High-Dose Melphalan in Autologous Haematopoietic Stem Cell Transplantation for Relapsed Multiple Myeloma—A Single Centre Retrospective Study"

Source

T.Silfverberg, H.Cherif, E.Smitt, and K.Carlson, “Adding Bortezomib and Bendamustine to High-Dose Melphalan in Autologous Haematopoietic Stem Cell Transplantation for Relapsed Multiple Myeloma—A Single Centre Retrospective Study.” eJHaem7, no. 2 (2026): e70288. https://doi.org/10.1002/jha2.70288 April 14, 2026.    

Overview

For myeloma patients who relapse after a first autologous transplant, a second transplant (ASCT2) is an established option, but responses are typically shorter than after the first. This retrospective single-center study from Uppsala University Hospital compared 43 patients who received a modified conditioning regimen — bortezomib, bendamustine, and melphalan (BBM) — before ASCT2 against 43 historical controls who received standard high-dose melphalan (HDM).

The BBM regimen was associated with a smaller decline in PFS between ASCT1 and ASCT2 compared to HDM — a 15% reduction versus 39% (p=0.012) — suggesting it partially offsets the diminishing returns typically seen with repeat transplantation. Median OS after ASCT2 was 72.2 months with BBM versus 51.5 months with HDM, though this difference did not reach statistical significance (p=0.14). The reduction in time to next treatment was also less pronounced with BBM (26% versus 39%), though again not statistically significant. Severe adverse events were broadly similar between groups, with a non-significant trend toward more febrile neutropenia with BBM. The results are hypothesis-generating rather than definitive given the retrospective design and matched cohort of 43 patients per arm, and the authors call for prospective trials to confirm whether BBM conditioning offers a meaningful efficacy advantage in the second transplant setting

"Benefit of selinexor dose reduction on outcomes with selinexor, bortezomib and dexamethasone in patients with lenalidomide-refractory multiple myeloma: Subgroup analysis of the BOSTON trial"

Source

Delimpasi, S., Špička, I., Butler, J.P., Stevens, D.A., Mesa, M.G., Bygrave, C., Merlo, G.M., la Porte, C. and Dimopoulos, M.A. (2026), Benefit of selinexor dose reduction on outcomes with selinexor, bortezomib and dexamethasone in patients with lenalidomide-refractory multiple myeloma: Subgroup analysis of the BOSTON trial. Br J Haematol. https://doi.org/10.1111/bjh.70479 April 14, 2026.     

Overview

This post-hoc analysis of the phase 3 BOSTON trial examined outcomes specifically in lenalidomide-refractory myeloma patients who received selinexor, bortezomib, and dexamethasone (SVd) and underwent selinexor dose reduction from the 100 mg weekly starting dose. Of 53 lenalidomide-refractory patients who received SVd, 35 had dose reductions and 18 did not. Despite having numerically higher rates of poor performance status and high-risk cytogenetic abnormalities, the dose-reduction group fared substantially better across efficacy measures: ORR 74.3% versus 55.6%, VGPR or better 48.6% versus 11.1%, median PFS 13.9 versus 5.1 months, and median duration of response 15.3 versus 4.2 months. Time to next treatment more than tripled in the dose-reduction group (14.8 versus 4.8 months), and patients in that group remained on treatment a median of 7.9 months compared to 2.5 months without reduction.

The mechanism behind the efficacy advantage appears to be tolerability-driven: dose reduction substantially reduced gastrointestinal side effects and fatigue — selinexor's most common non-hematologic toxicities — allowing patients to stay on treatment longer and accumulate deeper responses. Quality of life scores improved meaningfully after dose reduction, with the mean improvement exceeding the 10-point threshold considered clinically significant. The authors note that a 13.9-month median PFS compares favorably to the 8.6 months seen with carfilzomib/dexamethasone and 9.5 months with pomalidomide/bortezomib/dexamethasone in lenalidomide-refractory populations in other phase 3 trials. The findings are exploratory given the small numbers and post-hoc design, but they suggest that proactive dose reduction — rather than treatment discontinuation — may be the more effective strategy when selinexor toxicity emerges.

"Safety and efficacy of ciltacabtagene autoleucel for relapsed/refractory multiple myeloma: a CIBMTR study"

Source

Hansen, D.K., Dima, D., Mian, H. et al. Safety and efficacy of ciltacabtagene autoleucel for relapsed/refractory multiple myeloma: a CIBMTR study. Blood Cancer J. (2026). https://doi.org/10.1038/s41408-026-01496-w April 14, 2026.  

Overview

This CIBMTR registry analysis represents the largest real-world dataset on cilta-cel to date, covering 595 patients treated under standard-of-care conditions between March 2022 and December 2023. The population was heavily pretreated (median 7 prior lines of therapy), with 70% carrying at least one comorbidity — a markedly different profile from the clinical trial populations in which cilta-cel was initially studied. Despite this, the efficacy results were strong: an 87% overall response rate, 75% achieving VGPR or better, 35% achieving complete response or better, and 12-month PFS and OS of 73% and 85%, respectively.

On the safety side, cytokine release syndrome occurred in 80% of patients, though grade ≥3 cases were limited to 4%. ICANS affected 22%, also with 4% grade ≥3. The more closely watched toxicity in this dataset is non-ICANS neurotoxicity, which occurred in 5% of patients and included Parkinsonism in 2.7% and cranial nerve palsies in 2.5% — the latter predominantly involving cranial nerve VII (facial nerve). Infections occurred in 47% and treatment-related mortality was 5%. The neurotoxicity rates, while relatively low in absolute terms, are notable given that movement disorders and cranial nerve involvement after cilta-cel have drawn increasing attention as potentially serious delayed complications. The registry data confirm that cilta-cel's efficacy observed in trials translates to a broader, sicker real-world population, while also providing more precise estimates of rare toxicity rates than trial cohorts alone can offer.

"Proteomic profiling revealed unique disease biology associated with 1q abnormalities in multiple myeloma"

Source

Mangalaparthi, K.K., Hsu, JS., Wiedmeier-Nutor, J.E. et al. Proteomic profiling revealed unique disease biology associated with 1q abnormalities in multiple myeloma. npj Precis. Onc. (2026). https://doi.org/10.1038/s41698-026-01364-7 April 14, 2026.   

Overview

Gain or amplification of chromosome 1q (+1q) occurs in roughly 40% of myeloma patients and is associated with worse outcomes, particularly in relapsed disease, but its downstream molecular consequences at the protein level have not been well characterized. This study applied proteomic analysis to enriched CD138+ plasma cells from newly diagnosed myeloma patients to identify protein-level changes associated with +1q.

Differential expression analysis found increased expression of over 100 proteins encoded by the 1q chromosomal region in +1q cases, consistent with a gene dosage effect — more copies of the chromosomal region producing more of the proteins it encodes. Pathway analysis identified enrichment of cell cycle regulators including CDK1, the MCM complex, CHEK2, PSME3, and NEK7, pointing to accelerated proliferation as a downstream consequence of +1q. Protein interaction network analysis further revealed enrichment of MYC transcriptional targets, and highlighted TIPRL — encoded at 1q24 — as a protein of particular interest. Elevated TIPRL transcript expression correlated with +1q across cytogenetic subgroups in the CoMMpass dataset, and high TIPRL expression specifically predicted poor prognosis in patients with hyperdiploidy. The findings position TIPRL as a candidate target for functional follow-up studies and illustrate how proteomic profiling can translate chromosomal abnormalities into specific, actionable molecular vulnerabilities.

"Significant burden of low-grade infections in patients treated with T-cell−engaging therapies for multiple myeloma"

Source

Julia Mersi, Lara Burow, Xiang Zhou, Florian Eisele, Matthias Fante, Christine Riedhammer, August Stich, Nora Isberner, Nazia Afrin, Johannes Duell, Max S. Topp, Hermann Einsele, Johannes Waldschmidt, K. Martin Kortüm, Leo Rasche; Significant burden of low-grade infections in patients treated with T-cell−engaging therapies for multiple myeloma. Blood Adv 2026; 10 (7): 2244–2248. doi: https://doi.org/10.1182/bloodadvances.2025017889  April 14, 2026.    

Overview

This single-center retrospective study from Würzburg characterized the full spectrum of infectious complications — including low-grade infections typically underreported in clinical trials — in 137 heavily pretreated myeloma patients receiving BCMA-directed CAR-T (n=58), BCMA bispecific antibodies (n=47), or GPRC5D bispecific antibodies (n=32). Infections occurred in 76–85% of patients across all three groups. Severe (grade ≥3) infections were less frequent than in published trial data — 19%, 19%, and 8% respectively — which the authors attribute partly to routine immunoglobulin prophylaxis when IgG fell below 400 mg/dL. All five fatal infections in the CAR-T group occurred within three months of infusion and were associated with high-grade neutropenia. GPRC5D-directed bispecific therapy showed a consistently more favorable infection profile than BCMA-directed bispecific therapy across severity, hospitalization rate, and ICU admission.

The study's most distinctive finding concerns low-grade infections, which accounted for over 80% of all infectious events and are rarely captured systematically in trials. Patients on BCMA bispecific antibodies experienced infectious symptoms during approximately 20% of their treatment time — roughly 6 days per month — compared to 9% of treatment time (about 2.7 days per month) for GPRC5D bispecific antibody recipients. These prolonged, recurrent low-grade infections meaningfully impaired quality of life despite rarely requiring hospitalization. The authors argue that infection burden metrics — such as symptomatic days per month — offer a more complete picture of infectious morbidity than severity grading alone, and call for investigation of fixed-duration or reduced-maintenance dosing strategies to allow immune recovery in patients achieving deep responses.

"Belantamab mafodotin, bortezomib, and dexamethasone for RRMM in the Japan expansion cohort of the phase 3 DREAMM-7 trial"

Source

Fujisaki, T., Kubo, K., Hiramatsu, Y. et al. Belantamab mafodotin, bortezomib, and dexamethasone for RRMM in the Japan expansion cohort of the phase 3 DREAMM-7 trial. Int J Hematol (2026). https://doi.org/10.1007/s12185-026-04211-4  April 15, 2026.   

Overview

This report presents outcomes from the Japan expansion cohort of the phase 3 DREAMM-7 trial, which compared belantamab mafodotin plus bortezomib and dexamethasone (BVd) against daratumumab plus bortezomib and dexamethasone (DVd) in relapsed/refractory myeloma. The Japanese cohort was small — 10 patients on BVd and 14 on DVd — with a median follow-up of 19.4 months.

Results in the Japanese cohort were directionally consistent with the global trial. Median PFS was not reached with BVd versus 11.1 months with DVd (HR 0.40), and ORR was 90.0% versus 71.4%. Median duration of response was not reached with BVd versus 14.5 months with DVd. Ocular adverse reactions were more frequent with BVd, as expected given belantamab mafodotin's known corneal toxicity profile, and were managed with dose modification without new safety signals. The cohort is too small to draw independent conclusions, but the alignment with global DREAMM-7 results supports the applicability of BVd's efficacy and safety profile to Japanese patients with relapsed/refractory myeloma.

"Comparison of adverse event profiles of carfilzomib-, elotuzumab-, and ixazomib-based therapies combined with lenalidomide and dexamethasone in patients with multiple myeloma using VigiBase"

Source

Jun Matsumoto, Tatsuaki Takeda, Shiho Sugimoto, Tomonori Sakai, Beatrix Bermudo Loyao, Tsukasa Higashionna, Hirofumi Hamano, Gerard Lee Lo See, Noritaka Ariyoshi, Yoshito Zamami, Comparison of adverse event profiles of carfilzomib-, elotuzumab-, and ixazomib-based therapies combined with lenalidomide and dexamethasone in patients with multiple myeloma using VigiBase, Leukemia Research, Volume 166, 2026, 108236, ISSN 0145-2126, https://doi.org/10.1016/j.leukres.2026.108236. April 15, 2026.    

Overview

No randomized trial has directly compared the toxicity profiles of three lenalidomide/dexamethasone-based triplet regimens — carfilzomib (KRd), elotuzumab (EloRd), and ixazomib (IxaRd) — leaving clinicians without head-to-head safety data to inform treatment selection. This study used the WHO's VigiBase pharmacovigilance database to perform disproportionality analyses across 3,950 KRd, 1,210 EloRd, and 3,948 IxaRd adverse event reports filed through December 2024.

KRd showed significantly elevated reporting signals in hematologic and cardiac toxicity categories, with neutropenia and cardiac failure as the representative preferred terms — consistent with carfilzomib's established cardiovascular risk profile. IxaRd had the broadest toxicity signal, with disproportionate reporting across seven system organ classes, most prominently gastrointestinal disorders and nervous system disorders, with nausea and peripheral neuropathy as representative events. EloRd showed no significant disproportionality signals relative to either comparator, suggesting a narrower adverse event profile among the three regimens. The pharmacovigilance methodology captures signals from real-world reporting rather than controlled trial conditions, and is subject to underreporting and reporting bias, but the findings provide a practical framework for weighing regimen-specific toxicity risks — particularly cardiovascular vulnerability with KRd and neuropathy or gastrointestinal tolerance concerns with IxaRd — when selecting among these options for individual patients.

"Association between healthy lifestyle score and risk of multiple myeloma: a case–control study"

Source

Khosroshahi, R.A., Shahmohammadi, F., Ebrahimi-Mousavi, S. et al. Association between healthy lifestyle score and risk of multiple myeloma: a case–control study. Sci Rep (2026). https://doi.org/10.1038/s41598-026-48540-0 April 15, 2026.    

Overview

Higher HLS was associated with substantially lower odds of myeloma in a dose-response pattern. Compared to the lowest tertile, patients in the middle and highest tertiles had adjusted odds ratios of 0.48 and 0.20 respectively, and each one-point increase in HLS corresponded to a 49% reduction in myeloma odds (OR 0.51, p<0.001). When individual components were examined separately, smoking and BMI drove the associations, while physical activity and Mediterranean Diet adherence were not independently significant after adjustment for the other variables. The case-control design limits causal inference — lifestyle behaviors may have changed after diagnosis, and hospital-based controls may not represent the general population — and the authors appropriately call for prospective studies to establish whether the associations reflect true pre-disease exposure patterns rather than reverse causation or confounding.

This hospital-based case-control study from Iran examined the relationship between a composite Healthy Lifestyle Score (HLS) and myeloma risk in 149 newly diagnosed myeloma patients and 359 controls, recruited between August 2020 and March 2024. The HLS combined four components — diet (Mediterranean Diet adherence), physical activity, BMI, and smoking — into a score from 0 to 4.

"Cyclophosphamide-pomalidomide combination alters the tumour cell secretome and enhances the anti-myeloma activity of elotuzumab through NK cell-mediated cytotoxicity"

Source

Claire L. Feerick, Lei Lei, Dawn Swan, Niamh A. Leonard, Kevin Lynch, Oliver Treacy, Thomas Ritter, Janusz Krawczyk, Michael O'Dwyer, Aideen E. Ryan, Cyclophosphamide-pomalidomide combination alters the tumour cell secretome and enhances the anti-myeloma activity of elotuzumab through NK cell-mediated cytotoxicity, International Immunopharmacology, Volume 175, 2026, 116222, ISSN 1567-5769,

https://doi.org/10.1016/j.intimp.2026.116222. April 15, 2026.   

Overview

Elotuzumab targets SLAMF7, a protein expressed on both myeloma cells and natural killer (NK) cells, and exerts its anti-myeloma effect primarily by enhancing NK cell-mediated killing. This preclinical study investigated whether cyclophosphamide (CTX) — a chemotherapy agent that can alter the tumor microenvironment — might augment elotuzumab's mechanism when combined with pomalidomide, and whether adding immune checkpoint blockade could further potentiate NK cell activity.

The investigators collected secreted factors from myeloma cells treated with CTX, pomalidomide, or both, then exposed primary human NK cells to these conditioned media and assessed NK cell behavior. CTX alone and in combination with pomalidomide altered the tumor secretome in ways that promoted NK cell recruitment and cytotoxicity, while preserving SLAMF7 expression on myeloma cells — a prerequisite for elotuzumab activity. NK cells conditioned by CTX-treated tumor secretome showed enhanced elotuzumab-mediated killing. The study also found that CTX and pomalidomide treatment induced PD-L1 and CD47 expression on myeloma cells — immune checkpoint molecules that can blunt NK cell activity — and that simultaneously blocking both with anti-PD-1 and anti-CD47 antibodies significantly increased NK cytotoxicity and production of TNF-α and granzyme B. The findings are entirely in vitro but provide mechanistic rationale for adding cyclophosphamide to elotuzumab-containing regimens and for combining pomalidomide with dual checkpoint blockade targeting PD-L1 and CD47 as a strategy to maximize NK cell-mediated anti-myeloma effects.

"Can Belantamab mafodotin cause macro LDH?"

Source

Hakakian, L., Shragai, T., Trestman, S., Cohen, Y. C., Katz, B. Z., Arafat, N., … Avivi, I. (2026). Can Belantamab mafodotin cause macro LDH? Leukemia & Lymphoma, 1–6. https://doi.org/10.1080/10428194.2026.2649877 April 16, 2026.    

Overview

Lactate dehydrogenase (LDH) is routinely monitored in myeloma as a marker of disease activity and tumor burden, and elevated levels typically prompt concern for progressive disease or organ involvement. This retrospective single-center study of 40 relapsed/refractory myeloma patients treated with belantamab mafodotin found that 67.5% developed elevated LDH during treatment. Six of these patients underwent thorough clinical evaluation and were diagnosed with Macro-LDH — a benign phenomenon in which LDH binds to immunoglobulins, artificially elevating measured levels without reflecting true tissue damage or disease progression. LDH levels normalized after belantamab mafodotin was stopped in all affected patients, and multivariate analysis found that a higher cumulative number of treatment cycles was significantly associated with elevated LDH (OR 1.11, p=0.045).

This appears to be the first report linking belantamab mafodotin to Macro-LDH formation. The clinical relevance is straightforward: in myeloma patients on belantamab mafodotin who develop elevated LDH without other signs of progression, Macro-LDH should be considered before initiating additional workup for disease relapse or organ injury. Recognizing this benign drug-associated phenomenon could spare patients unnecessary imaging, bone marrow biopsies, and clinical anxiety, while avoiding healthcare costs tied to investigations that would ultimately prove unrevealing.

"Whole-genome sequencing of cell-free DNA for assessment of minimal residual disease in high-risk smoldering multiple myeloma"

Source

Baker, C., Hill, E., Kazandjian, D., Papadimitriou, M., Durante, M., Pandey, A., Ziccheddu, B., Jelinek, T., Coffey, D., Walker, B., Young, R., Maclachlan, K., Korde, N., Parkinson, N., Goldstein, Z.R., Runnels, A., Hooper, W.F., Landau, D., Robine, N., Maura, F., Landgren, O. and Diamond, B. (2026), Whole-genome sequencing of cell-free DNA for assessment of minimal residual disease in high-risk smoldering multiple myeloma. HemaSphere, 10: e70367. https://doi.org/10.1002/hem3.70367  April 16, 2026.  

Overview

Minimal residual disease (MRD) assessment in myeloma currently relies on bone marrow biopsy, which is invasive, samples only a focal region of the marrow, and can miss disease that is spatially heterogeneous or present outside the biopsy site. This study evaluated a blood-based alternative: tumor-informed whole-genome sequencing (WGS) of circulating cell-free DNA (cfDNA), applied longitudinally in 25 high-risk smoldering myeloma patients across 87 sequential plasma samples.

Using each patient's baseline tumor WGS to inform personalized mutation tracking, the approach achieved a median limit of detection of 1.2 × 10⁻⁴ — sensitive enough to detect low levels of circulating tumor DNA in the MRD range. Baseline tumor fraction was prognostic, and tumors with high-risk genomic features had higher baseline tumor fraction and were more likely to progress. Dynamic changes in serially tracked tumor fraction over time also predicted outcome. Compared to standard bone marrow flow cytometry MRD testing, cfDNA WGS was concordant in 73.3% of paired samples, reliably captured bone marrow-positive cases, and in several instances detected residual disease that bone marrow flow cytometry missed — likely reflecting spatial heterogeneity or focal disease outside the biopsy site. The findings position tumor-informed cfDNA WGS as a complementary tool to bone marrow MRD assessment rather than a replacement, adding systemic and longitudinal resolution that a single marrow sample cannot provide. Whether serial blood-based MRD tracking can guide treatment decisions — such as when to intensify or discontinue therapy — in smoldering or active myeloma remains to be prospectively validated.

"Monocyte-mediated metabolic rewiring via CD31-CD38 interactions promotes growth and drug-resistance in multiple myeloma"

Source

Raoof, R., Dal Collo, G., Simon-Molas, H., Tzortzi, P., Kulaj, K., Demirez, E.N., Massaro, C., Poels, R., Korst, C.L.B.M., O'Neill, C.A., Bruins, W.S.C., Broekmans, M.E.C., Behradkia, P., Krevvata, M., Zweegman, S., Kater, A.P., Baglio, S.R., Mutis, T. and van de Donk, N.W.C.J. (2026), Monocyte-mediated metabolic rewiring via CD31-CD38 interactions promotes growth and drug-resistance in multiple myeloma. HemaSphere, 10: e70358. https://doi.org/10.1002/hem3.70358 April 16, 2026.   

Overview

Myeloma cells do not survive in isolation — they depend heavily on interactions with other cells in the bone marrow microenvironment. This preclinical study identifies a previously unrecognized mechanism through which monocytes support myeloma cell survival: direct transfer of mitochondria to myeloma cells via a CD38/CD31 (PECAM-1) molecular interaction. Receiving these mitochondria increased myeloma cells' oxidative phosphorylation (OXPHOS) activity, and this metabolic boost promoted myeloma cell growth, motility, and resistance to therapy in both cell lines and primary patient samples.

The study's most clinically relevant finding concerns daratumumab, the widely used anti-CD38 monoclonal antibody. By blocking CD38 on myeloma cells, daratumumab disrupted the mitochondrial transfer mechanism — reducing mitochondrial content in myeloma cells, suppressing OXPHOS, and impairing growth, migration, and drug resistance. In the presence of daratumumab, the transfer dynamic reversed: monocytes instead acquired mitochondria from myeloma cells through trogocytosis. The findings add a previously unappreciated dimension to daratumumab's mechanism of action beyond immune-mediated cell killing, and suggest that disrupting tumor metabolism through CD38 targeting may contribute meaningfully to its clinical efficacy. The results also provide mechanistic rationale for combining daratumumab or other CD38-targeting agents with therapies that target mitochondrial metabolism in myeloma.

"Distinct trajectory of measurable residual disease in t(11;14) myeloma treated with quadruplet therapy"

Source

Susan Bal, Gayathri Ravi, Binod Dhakal, Natalie S. Callander, Eva Medvedova, Bhagirathbhai R. Dholaria, Smith Giri, Kelly N. Godby, Rebecca W. Silbermann, Fady M. Mikhail, Forest Huls, Vishnu Reddy, Luciano J. Costa; Distinct trajectory of measurable residual disease in t(11;14) myeloma treated with quadruplet therapy. Blood 2026; 147 (16): 1857–1862. doi: https://doi.org/10.1182/blood.2025031952  April 16, 2026. 

Overview

This small prospective pilot study compared two PET radiotracers — the standard ¹⁸F-FDG and the alternative ¹¹C-acetate — across both PET/CT and PET/MRI platforms in seven myeloma patients, with each patient undergoing all four imaging combinations. ¹¹C-acetate detected more lesions and produced higher visual conspicuity scores than ¹⁸F-FDG on both platforms. No meaningful advantage was observed for PET/MRI over PET/CT in this protocol, which used neither functional MRI sequences nor contrast enhancement.

The findings are preliminary given the seven-patient cohort and the limited MRI protocol, but they add to a small body of evidence suggesting ¹¹C-acetate may outperform ¹⁸F-FDG for myeloma lesion detection — potentially because myeloma cells rely heavily on lipid metabolism, which ¹¹C-acetate traces, rather than the glycolytic pathway that ¹⁸F-FDG captures. Whether ¹¹C-acetate's apparent sensitivity advantage translates into clinically meaningful differences in staging or response assessment will require larger prospective studies with full MRI protocols.

"Prospective Pilot Study of 11C-acetate and 18F-FDG with PET/CT and PET/MRI for Lesion Detection in Multiple Myeloma"

Source

Yancey, K., Han, W., Yang, M. et al. Prospective Pilot Study of 11C-acetate and 18F-FDG with PET/CT and PET/MRI for Lesion Detection in Multiple Myeloma. Mol Imaging Biol (2026). https://doi.org/10.1007/s11307-026-02099-4 April 16, 2026.   

Overview

This small prospective pilot study compared two PET radiotracers — the standard ¹⁸F-FDG and the alternative ¹¹C-acetate — across both PET/CT and PET/MRI platforms in seven myeloma patients, with each patient undergoing all four imaging combinations. ¹¹C-acetate detected more lesions and produced higher visual conspicuity scores than ¹⁸F-FDG on both platforms. No meaningful advantage was observed for PET/MRI over PET/CT in this protocol, which used neither functional MRI sequences nor contrast enhancement.

The findings are preliminary given the seven-patient cohort and the limited MRI protocol, but they add to a small body of evidence suggesting ¹¹C-acetate may outperform ¹⁸F-FDG for myeloma lesion detection — potentially because myeloma cells rely heavily on lipid metabolism, which ¹¹C-acetate traces, rather than the glycolytic pathway that ¹⁸F-FDG captures. Whether ¹¹C-acetate's apparent sensitivity advantage translates into clinically meaningful differences in staging or response assessment will require larger prospective studies with full MRI protocols.

"N-Acetylornithine Depletion in Bone Marrow Biopsy: A Novel Microenvironment-Specific Hallmark for Multiple Myeloma Diagnosis"

Source

B.Wang, S.Xie, W.Xie, et al., “N-Acetylornithine Depletion in Bone Marrow Biopsy: A Novel Microenvironment-Specific Hallmark for Multiple Myeloma Diagnosis,” International Journal of Laboratory Hematology (2026): 1–9, https://doi.org/10.1111/ijlh.70116. April 17, 2026 

Overview

Metabolomic profiling of bone marrow has previously focused on suspension fluid and plasma; direct analysis of biopsy tissue has been technically challenging and rarely reported. This study developed a high-performance liquid chromatography-mass spectrometry approach for metabolomic profiling of bone marrow biopsy tissue and applied it to 19 newly diagnosed myeloma patients, 29 MGUS patients, and 30 lymphoma patients without bone marrow involvement serving as controls.

Metabolic profiles differed meaningfully across all three groups. The most consistent finding was reduced N-acetylornithine in myeloma relative to both MGUS and controls. Comparing myeloma to controls, N-acetylornithine achieved an AUC of 0.933 with 90% sensitivity and 93.3% specificity — a strong diagnostic signal for a single metabolite. In the MGUS versus myeloma comparison, N-acetylornithine again showed the best diagnostic performance (87.5% sensitivity, 71.4% specificity), and pathway analysis identified disrupted arginine biosynthesis — the pathway in which N-acetylornithine participates — as significantly altered in myeloma relative to MGUS. The cohort is small and the findings require validation in larger prospective studies, but the tissue-based metabolomic approach itself is a methodological contribution, and N-acetylornithine emerges as a candidate biomarker for distinguishing myeloma from its precursor state that warrants further investigation.

"Real-World Treatment Patterns and Outcomes for Patients With Relapsed/Refractory Multiple Myeloma and Prior Exposure to Lenalidomide and Proteasome Inhibitors in the United States"

Source

Luciano J. Costa, Sandhya Nair, Marguerite O’Hara, Mary Slavcev, Niodita Gupta-Werner, Margaret Doyle, Eric Ammann, Sunny Patel, Xiwu Lin, Maria-Victoria Mateos, Real-World Treatment Patterns and Outcomes for Patients With Relapsed/Refractory Multiple Myeloma and Prior Exposure to Lenalidomide and Proteasome Inhibitors in the United States, Clinical Lymphoma Myeloma and Leukemia, 2026, ISSN 2152-2650, https://doi.org/10.1016/j.clml.2026.04.009. April 18, 2026.  

Overview

This real-world analysis used the Flatiron Health database to characterize treatment patterns and outcomes in 1,858 myeloma patients receiving early relapsed/refractory therapy between January 2021 and January 2025. The cohort was restricted to patients who had received one to three prior lines including a proteasome inhibitor and lenalidomide, were BCMA-therapy naive, and were not daratumumab-refractory — representing a population increasingly encountered in clinical practice as frontline quadruplet regimens become standard. High-risk cytogenetics were present in 35.7% and prior daratumumab exposure in 29.4%.

Treatment selection was highly variable, with no dominant regimen emerging across lines. At a median follow-up of 24.5 months, median real-world PFS was 10.1 months and median time to next treatment was 12.7 months — both short intervals reflecting rapid disease evolution despite relatively early relapse status. Median OS had not been reached. Higher ECOG performance status, high-risk cytogenetics, and lenalidomide-refractory status were the strongest predictors of worse PFS and OS in univariate analyses. The 10-month median PFS in this early-relapse, BCMA-naive population — which would be considered eligible for bispecific antibodies or CAR-T in many centers — illustrates the gap between current standard-of-care outcomes and what newer immunotherapies achieve in trials, and provides a quantitative benchmark against which earlier deployment of those therapies could be measured.

"The Role of Genomics in the Development and Treatment of Multiple Myeloma: Understanding the Challenges and Opportunities"

Source

Ren L, Ru F, Zhang K. The Role of Genomics in the Development and Treatment of Multiple Myeloma: Understanding the Challenges and Opportunities. Onco Targets Ther. 2026;19:595435 
https://doi.org/10.2147/OTT.S595435 April 18, 2026.   

Overview

This review synthesizes current knowledge on myeloma genomics and its translation into clinical practice, organized around the major categories of genomic abnormality that drive disease biology. The authors cover key driver mutations — including NRAS/KRAS, TP53, and MYC — copy number variations with particular attention to 1q21 amplification, epigenetic dysregulation through DNA methylation and histone modifications, and the roles of non-coding RNAs in disease progression and drug resistance. The rapid expansion of next-generation sequencing and single-cell sequencing technologies has made it possible to characterize myeloma's genomic heterogeneity at a resolution not previously achievable, and the review frames these advances in terms of their direct clinical relevance rather than basic science alone.

The clinical applications the authors emphasize include risk stratification based on genomic features, treatment selection informed by specific mutations or cytogenetic abnormalities, MRD monitoring, and early detection of relapse through liquid biopsy approaches. The review also addresses how genomic complexity underlies the considerable variability in prognosis and treatment response seen across patients — a central challenge in myeloma management that genomic profiling is beginning to address more systematically. While the review covers established findings alongside emerging data, its practical orientation toward precision diagnosis and treatment selection makes it a useful reference for clinicians seeking to understand how genomic information is moving from research into routine care decisions.

"Impact of Pretransplant CONUT Score on Posttransplant Engraftment Kinetics and Overall Survival in Patients with Multiple Myeloma"

Source

Süleyman Arslan, Mehmet Ali Erkurt, İrfan Kuku, Emin Kaya, İlhami Berber, Ahmet Sarıcı, Ahmet Kaya, Title of the manuscript: "Impact of Pretransplant CONUT Score on Posttransplant Engraftment Kinetics and Overall Survival in Patients with Multiple Myeloma", Transfusion and Apheresis Science, 2026, 104433, ISSN 1473-0502, https://doi.org/10.1016/j.transci.2026.104433. April 18, 2026.  

Overview

The Controlling Nutritional Status (CONUT) score — a composite of serum albumin, total cholesterol, and lymphocyte count — provides an objective measure of nutritional and immunological status that can be calculated from routine pre-transplant labs. This retrospective single-center study examined whether pre-transplant CONUT score predicted engraftment kinetics and clinical outcomes in 314 myeloma patients undergoing autologous transplant, stratifying patients into normal, mild, moderate, and severe malnutrition categories.

Neutrophil engraftment did not differ across nutritional groups, but patients with severe malnutrition had delayed platelet engraftment compared to those with normal nutritional status. Although CD34+ cell dose varied across CONUT groups — with better-nourished patients receiving higher doses — covariance analysis indicated that platelet engraftment delay was not independently driven by CD34+ dose after adjustment. Higher CONUT scores correlated with greater platelet and red blood cell transfusion requirements and higher rates of transfusion dependence beyond day +14. Pre-transplant treatment response was the strongest independent predictor of overall survival, while CONUT score did not independently predict long-term survival. The practical implication is that pre-transplant nutritional assessment using CONUT may help identify patients likely to need more intensive early post-transplant supportive care — a clinically useful signal even without a survival impact, given that transfusion burden and prolonged hospitalization carry meaningful consequences for patients and healthcare resources

"Environmental exposures and multiple myeloma risk: A contemporary review of epidemiologic associations and mechanistic plausibility"

Source

Maria Victoria del Rosal, Mike Z. He, Sundar Jagannath, Samir Parekh, Itai Kloog, Manish Arora, Santiago Thibaud, Environmental exposures and multiple myeloma risk: A contemporary review of epidemiologic associations and mechanistic plausibility, Blood Reviews, 2026, 101392, ISSN 0268-960X, https://doi.org/10.1016/j.blre.2026.101392. April 18, 2026  

Overview

Despite substantial progress in understanding myeloma's genomic landscape and developing effective treatments, the environmental factors that contribute to disease onset remain poorly characterized. This review synthesizes epidemiologic and mechanistic evidence linking environmental and occupational exposures to myeloma risk, focusing on pesticides, dioxins, and combustion byproducts — the categories with the most consistent associative data. Proposed biological mechanisms include oxidative stress, DNA damage, and signaling through the aryl hydrocarbon receptor, a pathway activated by many environmental contaminants and involved in immune regulation and cell proliferation.

The authors are candid about the limitations of the existing evidence: studies are heterogeneous in design, exposure assessment is imprecise, and the data are largely associative rather than causal. Establishing causality is methodologically difficult given the long latency between exposure and myeloma diagnosis, the rarity of the disease, and the challenge of accurately reconstructing lifetime environmental exposures. The review identifies three priorities for future research: more rigorous exposure measurement, cohort studies with linked biospecimens that allow biological mechanism to be studied alongside epidemiologic outcomes, and integrative analyses connecting environmental exposure data with myeloma genomics. The last point is particularly relevant given that some environmental mutagens produce characteristic mutational signatures that could, in principle, be traced in myeloma genomes — a connection the field has not yet systematically explored.

"Real-World Description of Non-ICANS Neurologic Events Among Patients with Relapsed or Refractory Multiple Myeloma Treated with Ciltacabtagene Autoleucel Using Two Large US Databases"

Source

Sidana, S., Nagar, S.P., Ghosh, S. et al. Real-World Description of Non-ICANS Neurologic Events Among Patients with Relapsed or Refractory Multiple Myeloma Treated with Ciltacabtagene Autoleucel Using Two Large US Databases. Oncol Ther (2026). https://doi.org/10.1007/s40487-026-00433-y April 18, 2026. 

Overview

Cilta-cel carries a recognized risk of non-ICANS neurologic events — including parkinsonism, cranial nerve palsy, and Guillain-Barré syndrome — that are distinct from the cytokine-mediated neurotoxicity (ICANS) more commonly discussed with CAR-T therapies. This retrospective real-world study used two independent data sources (Komodo insurance claims and Loopback electronic medical records) to characterize these events in patients treated with cilta-cel after either 1–3 or ≥4 prior lines of therapy, covering infusions from February 2021 through late 2024.

In the earlier-line group (1–3 prior lines), cranial nerve palsy occurred in approximately 5% of patients across both databases over a median follow-up of 3.4–3.5 months, with no parkinsonism or Guillain-Barré syndrome observed. In the more heavily pretreated group (≥4 prior lines), followed for a median of 13.2–13.3 months, parkinsonism occurred in 1.0% in both databases, cranial nerve palsy in 1.0–4.6%, and Guillain-Barré syndrome in 0.2–0.5%. The shorter follow-up in the earlier-line cohort limits direct comparison between groups and may underestimate event rates. Overall, the rates observed were comparable to or lower than those reported in CARTITUDE-1 and CARTITUDE-4 and in prior real-world analyses, providing some reassurance that the neurologic toxicity profile seen in trials generalizes to routine clinical practice across a broader patient population.

"Prognostic Impact of Chromosome 1q Gain/Amplification in Multiple Myeloma Treated With Daratumumab-Based Regimens"

Source

E. Barbieri, L. Arletti, M. Quaresima, et al., “Prognostic Impact of Chromosome 1q Gain/Amplification in Multiple Myeloma Treated With Daratumumab-Based Regimens,” European Journal of Haematology (2026): 1–13, https://doi.org/10.1111/ejh.70198. April 19, 2026.  

Overview

Chromosome 1q gain or amplification (+1q) is one of the most common cytogenetic abnormalities in myeloma and is included in current high-risk stratification systems, but whether it retains its adverse prognostic impact in patients treated with daratumumab-based regimens has not been well established. This single-center retrospective study examined 174 myeloma patients treated with daratumumab-based therapy between 2018 and 2023, stratifying the 92 patients with available cytogenetic data into four groups: standard risk, isolated +1q, +1q with additional high-risk cytogenetic abnormalities (+1q + HiRCAs), and non-1q high-risk abnormalities.

After a median follow-up of 30.7 months, isolated +1q was independently associated with significantly shorter PFS (HR 4.77) and time to next treatment (HR 3.83) compared to standard-risk patients, even after multivariate adjustment. Patients with +1q plus additional high-risk abnormalities fared worst across all endpoints, with PFS HR 7.67, TTNT HR 5.81, and OS HR 6.03 versus standard risk — results that remained consistent in the DaraRd subgroup specifically. The findings directly address a practical clinical question: daratumumab-based combinations have substantially improved myeloma outcomes overall, but +1q — whether isolated or co-occurring with other high-risk features — retains independent adverse prognostic significance within this treatment context. Patients with +1q, particularly those with co-existing high-risk abnormalities, may warrant closer monitoring and earlier consideration of alternative or intensified strategies despite receiving daratumumab-based therapy.

"Ciltacabtagene autoleucel in high-risk smoldering multiple myeloma: the CAR-PRISM phase 2 trial"

Source

Nadeem, O., Cordas dos Santos, D.M., Nikiforow, S. et al. Ciltacabtagene autoleucel in high-risk smoldering multiple myeloma: the CAR-PRISM phase 2 trial. Nat Med (2026). https://doi.org/10.1038/s41591-026-04365-y April 20, 2026. 

Overview

This phase 2 study tested cilta-cel in high-risk smoldering myeloma — before progression to active disease — without induction or bridging therapy, asking whether early CAR-T intervention could achieve deep, sustained remissions in a population not yet requiring standard treatment. Twenty patients were enrolled, excluding those with greater than 40% marrow involvement. No dose-limiting toxicities occurred. Adverse events included cytokine release syndrome in all patients (100% grade 1/2), transient grade 3/4 cytopenias in 90%, and non-ICANS neurologic events in seven patients — four cranial nerve palsies that fully resolved and three patients with persistent grade 1 symptoms.

The efficacy results are striking: all 20 patients achieved MRD negativity at 10⁻⁶ sensitivity within two months of infusion, all 16 patients with more than six months of follow-up achieved complete response, and no progressions or deaths were observed at a median follow-up of 15.3 months. Treating smoldering myeloma with a therapy of this intensity — and toxicity profile — before active disease develops represents a significant shift from standard watch-and-wait or lenalidomide-based interception approaches, and raises questions about long-term durability, late toxicities including the movement disorder signal seen with cilta-cel in other settings, and how to identify which smoldering patients benefit most. The results are early and the cohort small, but universal MRD negativity at 10⁻⁶ without a single progression is a benchmark no prior smoldering myeloma intervention has approached.

"Clinical characteristics, laboratory measures, and quality of life as predictors of medication adherence in multiple myeloma"

Source

Abu Hamdeh, N., Alnees, M., AbuAlrub, I. et al. Clinical characteristics, laboratory measures, and quality of life as predictors of medication adherence in multiple myeloma. Sci Rep (2026). https://doi.org/10.1038/s41598-026-49648-z April 20, 2026. 

Overview

This cross-sectional study enrolled 250 myeloma patients across five West Bank hospitals between 2018 and 2025, examining the relationship between quality of l…This cross-sectional study enrolled 250 myeloma patients across five West Bank hospitals between 2018 and 2025, examining the relationship between quality of life (QOL) and medication adherence. Patients completed the EORTC QLQ-MY20 disease-specific QOL measure at enrollment and were assessed for adherence one month later using the Morisky Medication Adherence Scale. Most patients showed medium (38.4%) or high (41.6%) adherence. Symptom burden was substantial, with lower back pain (76.4%), joint pain (69.2%), bone pain (63.6%), and constitutional symptoms (60.0%) reported frequently.

Ordinal logistic regression identified QOL domains — rather than demographic or laboratory variables — as the primary independent predictors of adherence. Better scores in Future Perspective and Body Image were associated with higher adherence, while greater symptom burden in the Side Effects and Disease Symptoms domains predicted lower adherence. The findings suggest that patients who feel more hopeful about their prognosis and less burdened by treatment side effects and disease symptoms are more likely to take their medications consistently — a relationship with direct clinical implications. Routine QOL monitoring integrated into myeloma follow-up visits could identify patients drifting toward non-adherence before it affects outcomes, and targeted supportive interventions addressing symptom burden and psychological wellbeing may help sustain adherence in patients at risk.

"International multicentre evaluation of a new anti-idiotypic anti-daratumumab for resolving pre-transfusion interferences"

Source

Reggiani A, Crottet SL, Waldvogel S, Engström C, Coluzzi S, Matteocci A, et al. International multicentre evaluation of a new anti-idiotypic anti-daratumumab for resolving pre-transfusion interferences. Vox Sang. 2026.  April 20, 2026. 

Overview

Daratumumab binds CD38, which is expressed on the reagent red blood cells used in standard pre-transfusion antibody testing, causing false-positive results that can mask clinically significant alloantibodies and complicate safe transfusion matching. Current workarounds — including dithiothreitol (DTT) and enzyme treatments — have limitations including destroying certain blood group antigens and reducing sensitivity for some alloantibodies. This 28-laboratory, 15-country study evaluated DaraClear, a novel anti-idiotypic antibody that neutralizes daratumumab interference by binding daratumumab itself rather than modifying red blood cells.

Across 443 daratumumab-containing plasma samples, DaraClear neutralized interference in 99.5%, with 86.2% resolved at the lowest (10%) concentration. Among 197 samples containing red blood cell alloantibodies, 96.4% were correctly detected, including weak and low-titre antibodies. Neutralization efficacy exceeded all comparators: DTT (93.3%), papain/trypsin (84.9%), and DaraEx (68.4%), with all differences statistically significant. The reagent did not require red blood cell modification, remained stable over time, and integrated into existing transfusion laboratory workflows without additional procedural complexity. As daratumumab use expands into earlier lines of myeloma therapy — meaning patients will be on it longer and require more transfusions over their disease course — a reliable, workflow-compatible solution to this interference problem has practical significance for transfusion safety.

"International multicentre evaluation of a new anti-idiotypic anti-daratumumab for resolving pre-transfusion interferences"

Source

Reggiani A, Crottet SL, Waldvogel S, Engström C, Coluzzi S, Matteocci A, et al. International multicentre evaluation of a new anti-idiotypic anti-daratumumab for resolving pre-transfusion interferences. Vox Sang. 2026.  April 20, 2026. 

Overview

Daratumumab binds CD38, which is expressed on the reagent red blood cells used in standard pre-transfusion antibody testing, causing false-positive results that can mask clinically significant alloantibodies and complicate safe transfusion matching. Current workarounds — including dithiothreitol (DTT) and enzyme treatments — have limitations including destroying certain blood group antigens and reducing sensitivity for some alloantibodies. This 28-laboratory, 15-country study evaluated DaraClear, a novel anti-idiotypic antibody that neutralizes daratumumab interference by binding daratumumab itself rather than modifying red blood cells.

Across 443 daratumumab-containing plasma samples, DaraClear neutralized interference in 99.5%, with 86.2% resolved at the lowest (10%) concentration. Among 197 samples containing red blood cell alloantibodies, 96.4% were correctly detected, including weak and low-titre antibodies. Neutralization efficacy exceeded all comparators: DTT (93.3%), papain/trypsin (84.9%), and DaraEx (68.4%), with all differences statistically significant. The reagent did not require red blood cell modification, remained stable over time, and integrated into existing transfusion laboratory workflows without additional procedural complexity. As daratumumab use expands into earlier lines of myeloma therapy — meaning patients will be on it longer and require more transfusions over their disease course — a reliable, workflow-compatible solution to this interference problem has practical significance for transfusion safety.

"Multiple myeloma cell segmentation based on position prior information guidance in medical imaging"

Source

Duantengchuan Li, Jiangyi Zhang, Yue Li, Qingbin Wang, Hui Shen, Chenghang Lai, Yuxin Tan, Fuling Zhou, Multiple myeloma cell segmentation based on position prior information guidance in medical imaging, Pattern Recognition, 2026, 113744, ISSN 0031-3203, https://doi.org/10.1016/j.patcog.2026.113744. April 21, 2026.  

Overview

Accurate segmentation of myeloma plasma cells in microscopy images is a prerequisite for automated diagnosis and disease monitoring, but background noise and the variable morphology of malignant plasma cells make this technically difficult. This study proposes PPGC, a segmentation framework that combines visual image features with text-derived semantic features from CLIP — a multimodal model trained to align images and text — to guide and constrain the identification of cell regions.

The approach works by extracting text features from CLIP and aligning them with visual features to focus the model's attention on relevant cell regions while suppressing background noise and irrelevant image responses. Global semantic information is used to highlight contextually similar pixels, and coarse initial positional estimates are iteratively refined through interaction with enhanced image features to produce precise cell boundaries. A positional loss function is incorporated during training to improve generalization. Tested on the publicly available SegPC dataset and a proprietary dataset from Zhongnan Medical Center, PPGC outperformed baseline segmentation methods on both. The work is entirely computational and would require prospective clinical validation before informing diagnostic workflows, but the use of multimodal semantic guidance to handle morphological diversity represents a methodologically distinct approach to a problem where standard segmentation methods have shown consistent limitations.

"A Bone Marrow-Targeted Nanomodulator as a Histone Lactylation Inhibitor for Reversing Immune Tolerance in Multiple Myeloma"

Source

Wu W, Zhang CL, Yang YL, Gao L, Zeng Y, Luo Z, Dong X, Zhang X, Chen X. A Bone Marrow-Targeted Nanomodulator as a Histone Lactylation Inhibitor for Reversing Immune Tolerance in Multiple Myeloma. ACS Nano. 2026 Apr 21. doi: 10.1021/acsnano.5c21396. Epub ahead of print.  

Overview

Myeloma cells and bone marrow macrophages engage in metabolic crosstalk that supports immune evasion and treatment resistance — myeloma cells produce lactate through glycolysis, which drives histone lactylation in macrophages and promotes an immunosuppressive M2 polarization state. This preclinical study introduces NanoCURE, a copper-based nanoparticle system designed to disrupt this glycolysis-lactate-lactylation axis and reverse the immunosuppressive bone marrow microenvironment.

NanoCURE encapsulates lactate oxidase and bortezomib within a copper nanoassembly that exploits the body's own monocyte and macrophage trafficking to achieve bone marrow-specific delivery — a strategy the authors term monocyte hijacking. Once delivered, the system operates through several simultaneous mechanisms: lactate oxidase depletes local lactate, directly blocking histone lactylation; copper ions suppress the Akt/mTOR/c-Myc signaling axis; and reactive oxygen species generation triggers mitochondrial dysfunction that amplifies epigenetic disruption. Together these effects reprogrammed immunosuppressive M2 macrophages toward a more antitumor state and enhanced bortezomib efficacy in an orthotopic mouse model. Systemic copper levels remained low and no organ toxicity or hematopoietic disruption was observed. The work is entirely preclinical, but the monocyte-hijacking delivery strategy and the simultaneous targeting of metabolic, epigenetic, and immune resistance mechanisms represent a conceptually distinct approach to overcoming proteasome inhibitor resistance in myeloma.

"Isatuximab: A Review in Transplant-Ineligible Newly Diagnosed Multiple Myeloma"

Source

Hoy, S.M. Isatuximab: A Review in Transplant-Ineligible Newly Diagnosed Multiple Myeloma. Targ Oncol (2026). https://doi.org/10.1007/s11523-026-01210-7  April 21, 2026.  

Overview

This review summarizes the evidence supporting isatuximab plus bortezomib, lenalidomide, and dexamethasone (Isa-VRd) for transplant-ineligible newly diagnosed myeloma, based on a phase 3 trial comparing Isa-VRd against VRd alone. Isa-VRd significantly prolonged PFS and produced deeper responses than VRd, while OS data remained immature at the time of analysis. Adding isatuximab to the VRd backbone did not meaningfully affect health-related quality of life, and the incremental toxicity was modest, consistent with isatuximab's established safety profile.

The approval of Isa-VRd in both the EU and US adds an anti-CD38 quadruplet option for transplant-ineligible patients — a population that has historically had fewer intensive treatment options than transplant-eligible patients. The review frames Isa-VRd as a clinically meaningful addition to this setting, while noting that mature OS data and longer follow-up are needed to fully characterize the survival benefit. The question of how Isa-VRd compares to daratumumab-based quadruplets in transplant-ineligible newly diagnosed myeloma — the other approved anti-CD38 combination in this setting — remains unanswered in the absence of head-to-head trial data.

"Clinical Benefit of Multiple Myeloma Drugs at Regulatory Approval in Brazil, Europe, and the USA: A Retrospective Cohort Study (2003–2024)"

Source

Rodrigues, M.A., de Pádua, C.A.M., de Miranda Drummond, P.L. et al. Clinical Benefit of Multiple Myeloma Drugs at Regulatory Approval in Brazil, Europe, and the USA: A Retrospective Cohort Study (2003–2024). Clin Drug Investig (2026). https://doi.org/10.1007/s40261-026-01552-0 April 21, 2026. 

Overview

This retrospective cohort study evaluated the magnitude of clinical benefit for myeloma drugs approved by the EMA, FDA, and Brazil's Anvisa between 2003 and 2024, using the ESMO Magnitude of Clinical Benefit Scale for Haematological Malignancies (ESMO-MCBS:H) applied to pivotal trial data extracted from regulatory documents. The EMA and FDA each approved 17 myeloma drugs over this period; Anvisa approved 12. A substantial proportion of approvals across all three agencies relied on single-arm studies — 64.7% for the EMA, 70.6% for the FDA — and expedited or accelerated pathways were common, particularly at the FDA where 64.7% used expedited review and 47.1% received Breakthrough Therapy designation.

Applying the ESMO-MCBS:H scoring, only 4 of 17 drugs (23.5%) demonstrated meaningful clinical benefit, defined as a grade ≥4 in the non-curative setting. The finding does not necessarily mean the remaining drugs lack value, but it raises important questions about the evidentiary standards underpinning myeloma drug approvals — particularly the reliance on single-arm trials and surrogate endpoints rather than randomized comparisons with overall survival data. The authors argue that ESMO-MCBS:H scoring should inform regulatory and reimbursement decisions, especially in resource-constrained settings where prioritization among approved agents is necessary. The analysis reflects a broader tension in oncology between the speed of drug approvals and the depth of evidence supporting them at the time patients begin paying for and receiving these treatments.

"Integrating Recent Evidence and Expert Perspectives Into the Management of Multiple Myeloma: Consensus Recommendations From the 2025 Bridging the Gaps Conference"

Source

A.Chari, C.Costello, A.Krishnan, et al., “Integrating Recent Evidence and Expert Perspectives Into the Management of Multiple Myeloma: Consensus Recommendations From the 2025 Bridging the Gaps Conference,” American Journal of Hematology (2026): 1–11, https://doi.org/10.1002/ajh.70339. April 21, 2026. 

Overview

The 2025 Bridging the Gaps Consensus Conference brought together 16 US myeloma experts to address treatment sequencing questions where clinical trial data remain insufficient or conflicting. Using a modified Delphi process, panelists reviewed evidence and voted on 51 questions, producing 11 consensus recommendations across smoldering myeloma, frontline therapy, transplant, maintenance, and relapsed/refractory disease.

The recommendations were not included in the provided abstract, but the three themes the authors identify as central — quadruplet induction as a standard consideration, individualized maintenance approaches, and early referral for CAR-T therapy — reflect the field's current directional movement rather than settled practice. The emphasis on early CAR-T referral is particularly notable given persistent gaps between when patients become eligible and when they actually receive cellular therapy, often due to delayed referral to transplant centers. Consensus documents of this kind serve a practical function in a disease where the pace of approvals has outrun the evidence base for sequencing decisions, offering clinicians structured expert guidance while prospective data accumulate.

"Teach-Back-Centered Multidimensional Health Education in Hospitalized Patients with Multiple Myeloma: a Single-Center Prospective Controlled Study of Quality of Life and Emotional Outcomes"

Source

Yan, X., Zhu, J., Zhao, W. et al. Teach-Back-Centered Multidimensional Health Education in Hospitalized Patients with Multiple Myeloma: a Single-Center Prospective Controlled Study of Quality of Life and Emotional Outcomes. J Canc Educ (2026). https://doi.org/10.1007/s13187-026-02873-6 April 21, 2026. 

Overview

This single-center prospective controlled study evaluated a teach-back–based, multidimensional intervention in 195 hospitalized patients with multiple myeloma. Patients in the intervention group (n=101) received structured teach-back education, along with psychological and lifestyle support, in addition to usual care; controls (n=94) received usual care alone. Outcomes included quality of life (EORTC QLQ-C30, a cancer-specific questionnaire), anxiety, depression, anger, disease knowledge, C-reactive protein (CRP), and immunoglobulin G (IgG). Linear mixed-effects models were used to estimate group differences, with effect sizes reported as Hedges g.

Quality of life improved in both groups, with a greater increase in the intervention group (Time×Group β=0.705; 95% CI 0.261–1.149; P=0.004; g=0.251). Anxiety, depression, and anger decreased in both groups, with larger reductions in the intervention group for anxiety (β=−0.173; 95% CI −0.341 to −0.006; P=0.009; g=−0.117), depression (β=−0.177; 95% CI −0.352 to −0.003; P=0.046; g=−0.112), and anger (β=−0.567; 95% CI −0.732 to −0.002; P=0.038; g=−0.682). Disease knowledge increased in both groups without a between-group difference (β=0.183; P=0.657). Exploratory analyses showed greater reductions in CRP (β=−3.442; 95% CI −6.296 to −1.411; P=0.014) and IgG (β=−0.632; 95% CI −0.988 to −0.276; P=0.043) in the intervention group. These biomarker findings were reported as exploratory.

"Advances in multiple myeloma: key updates from the ASH 2025 meeting"

Source

Naing, P.T., Baljevic, M. Advances in multiple myeloma: key updates from the ASH 2025 meeting. J Hematol Oncol 19, 27 (2026). https://doi.org/10.1186/s13045-026-01802-w  April 22, 2026. . 

Overview

This editorial reviews multiple myeloma data presented at the American Society of Hematology 2025 meeting, with a focus on bispecific antibodies (BsAbs), minimal residual disease (MRD)–adaptive strategies, and emerging immune platforms across disease stages. In newly diagnosed multiple myeloma (NDMM), MRD-adaptive consolidation with linvoseltamab in the IMMUNOPLANT study converted persistent MRD positivity to MRD negativity in all evaluable patients. In transplant-ineligible NDMM, the TecLille study reported deep responses with antibody-only therapy and manageable infection risk.

In relapsed or refractory multiple myeloma (RRMM), the phase III MajesTEC-3 trial showed improved progression-free survival and overall survival with teclistamab plus daratumumab compared with standard triplet regimens, with response rates approaching those reported with chimeric antigen receptor (CAR) T-cell therapy. The combination of elranatamab and iberdomide in MagnetisMM-30 showed activity with associated cytopenias, and updated results from RedirecTT-1 reported activity in extramedullary myeloma. First-in-human data from inMMyCAR introduced an in vivo CAR-T platform designed to generate CAR T cells directly in patients. Across studies, findings support earlier use of immunotherapy and MRD-guided treatment, with attention to infection risk and longer-term safety.

"A multi-center study of progression-risk and outcomes in solitary bone plasmacytoma with and without marrow involvement"

Source

Kenneth JC Lim, Maximilian Johannes Steinhardt, Matthew J. Rees, Patricia T. Greipp, Katalin Kelemen, Angela Dispenzieri, Dragan Jevremovic, Linda B Baughn, Francis K Buadi, David Dingli, Suzanne R Hayman, Prashant Kapoor, Eli Muchtar, Nelson Leung, Amie L Fonder, Miriam A Hobbs, Yi Lisa Hwa, Rahma Warsame, Taxiarchis V. Kourelis, Joselle Cook, Moritz Binder, Nadine Abdallah, Saurabh S. Zanwar, Yi Lin, Ronald S. Go, Mustaqeem Siddiqui, Ricardo D Parrondo, Sikander Ailawadhi, Vivek Roy, Rachel Elizabeth Cooke, Karen Dun, Adrian Carl Zordan, Slavisa Ninkovic, Sharene Best, Gabriela Alatorre, Julia Erin Wiedmeier-Nutor, K. Martin Kortüm, Hermann Einsele, Saurabh Chhabra, P. Leif Bergsagel, Robert A Kyle, Morie A Gertz, Shaji K Kumar, S. Vincent Rajkumar, Rafael Fonseca, Wilson I Gonsalves, Udit Yadav; A multi-center study of progression-risk and outcomes in solitary bone plasmacytoma with and without marrow involvement. Blood Adv 2026; bloodadvances.2025019136. doi: https://doi.org/10.1182/bloodadvances.2025019136 April 22, 2026. 

Overview

This multi-center study evaluated outcomes after radiation therapy (RT) in 243 patients with solitary bone plasmacytoma (SBP, n=141) or SBP with minimal marrow involvement (SBPmm, n=102) diagnosed between 2010 and 2024. Progression to multiple myeloma occurred in 92% of SBPmm patients compared with 76% of SBP patients (p=0.01). Among patients with SBP, 21% of progressions presented as a second solitary bone lesion versus 4% in SBPmm (p<0.01). Multifocal lytic bone lesions were the most common myeloma-defining event in both groups (89% in SBPmm; 81% in SBP).

Median time to progression (TTP) was shorter in SBPmm (15 months; 95% CI 14–21) than in SBP (43 months; 95% CI 34–55; p<0.0001), with 67% of SBPmm patients progressing within two years. In SBPmm, del(17p) and 1q+ (gain or amplification) were associated with shorter TTP, with 2-year progression rates of 100% and 82%, respectively. Patients with longer TTP after initial RT showed sustained responses to repeat RT for a second solitary lesion when no other myeloma-defining events were present. These findings describe differences in progression risk and pattern between SBP and SBPmm and provide a basis for evaluating upfront systemic therapy in SBPmm.

"Gene expression-based dissemination score predicts early spread and poor outcomes in multiple myeloma"

Source

Bohra, A., Dasari, S., Zanwar, S. et al. Gene expression-based dissemination score predicts early spread and poor outcomes in multiple myeloma. Leukemia (2026). https://doi.org/10.1038/s41375-026-02931-4 April 22, 2026.  

Overview

This study developed a gene expression–based dissemination score (DS) to quantify the transition of multiple myeloma from bone marrow–localized to systemic disease. Baseline plasma cell datasets, including RNA sequencing, microarray, and single-cell data, were analyzed. In the MMRF CoMMpass cohort (n=754), differential expression analysis of circulating plasma cells (n=592) and PET-CT–confirmed plasmacytomas (n=118), integrated with 1,114 EMT-related genes, identified 1,357 dissemination-associated genes. Elastic Net Cox regression generated a 30-gene DS that stratified overall survival (54.5 vs 102.5 months; C-index 0.71) and improved prognostic performance when combined with existing risk models (UAMS70, EMC92) in bootstrap analyses. DS was also associated with adverse stromal interaction profiles and further stratified high-risk microenvironmental interactions.

In an independent Mayo Clinic cohort (n=133), DS reproduced survival differences (52.1 vs 113.6 months; p<0.01) and predicted earlier dissemination events (2.1 vs 6.8 years; p<0.01). External datasets (GSE117156, GSE106218) showed higher DS in circulating and extramedullary plasma cells compared with marrow plasma cells (p<0.01), with scores increasing across disease stages from controls to multiple myeloma and related conditions. These results define DS as a measure of dissemination biology derived from plasma cell gene expression profiles.

"Validation and refinement of the new Consensus Genomic Staging (CGS) of high-risk multiple myeloma (HRMM) in relapsed and refractory patients treated with BCMA CAR-T"

Source

Gustine, J.N., Attar, N., Puliafito, B.R. et al. Validation and refinement of the new Consensus Genomic Staging (CGS) of high-risk multiple myeloma (HRMM) in relapsed and refractory patients treated with BCMA CAR-T. Blood Cancer J. (2026). https://doi.org/10.1038/s41408-026-01510-1 April 22, 2026. 

Overview

This retrospective study evaluated the updated Consensus Genomic Staging (CGS) criteria for high-risk multiple myeloma in 158 patients with relapsed or refractory disease treated with BCMA-directed CAR T-cell therapy. Seventy-five patients (47%) met criteria for high-risk disease. With a median follow-up of 24.8 months (95% CI 22.5–30.3), high-risk patients had shorter progression-free survival (PFS; HR 1.89, p=0.003) and overall survival (OS; HR 3.06, p<0.001) compared with standard-risk patients. Elevated lactate dehydrogenase (LDH >210 U/L) and extramedullary disease (EMD) were independent adverse factors on multivariable analysis.

A revised staging approach incorporated LDH and EMD into the CGS framework, defining four risk groups. Median PFS was 35.0 months in low risk (standard-risk, normal LDH, no EMD; n=42), 19.6 months in intermediate-low risk (high-risk, normal LDH, no EMD; n=31), 10.4 months in intermediate-high risk (standard-risk with elevated LDH, EMD, or both; n=41), and 6.6 months in high risk (high-risk with elevated LDH, EMD, or both; n=44) (p<0.0001). Estimated 24-month OS rates were 90%, 69%, 66%, and 26%, respectively (p<0.0001). These data define risk groups with distinct outcomes after BCMA CAR T-cell therapy using CGS with additional clinical factors.

"Real-world treatment patterns and outcomes of patients with multiple myeloma initiating elranatamab: results from the ALTITUDE-1 and ALTITUDE-2 retrospective cohort studies"

Source

Banerjee, R., Mohan, M., Shah, B., Prince, P., Gautam, N., Beebe, E., … DiBonaventura, M. (2026). Real-world treatment patterns and outcomes of patients with multiple myeloma initiating elranatamab: results from the ALTITUDE-1 and ALTITUDE-2 retrospective cohort studies. Future Oncology, 1–10. https://doi.org/10.1080/14796694.2026.2662504  April 23, 2026. 

Overview

TThis analysis reports real-world outcomes for elranatamab in patients with relapsed or refractory multiple myeloma using two US datasets (ALTITUDE-1 claims data; ALTITUDE-2 fee-for-service data). Patients initiating treatment after August 2023 were followed through September–October 2025. A total of 183 patients (ALTITUDE-1) and 391 patients (ALTITUDE-2) were included, with median ages of 73 and 75 years. Prior treatment exposure was extensive, with 43.2% and 33.0% of patients penta-drug exposed and 17.5% and 21.0% previously exposed to BCMA-targeted therapy.

Observed treatment patterns showed lower dosing intensity than the approved schedule, with 27.9 and 27.1 vials per year compared with 39 vials per year on label. Median time to next treatment or death and median overall survival were not reached. Landmark analyses estimated 18-month survival rates of 70.0% in ALTITUDE-1 and 60.7% in ALTITUDE-2. These data describe treatment patterns and outcomes in a heavily pretreated population, with survival estimates comparable to those reported in the MagnetisMM-3 study.

"Identifying High-Risk Smoldering Multiple Myeloma for Early Intervention"

Source

Maeng CV, Rögnvaldsson S, Brieghel C, et al. Identifying High-Risk Smoldering Multiple Myeloma for Early Intervention. JAMA Oncol. Published online April 23, 2026. doi:10.1001/jamaoncol.2026.0831 April 23, 2026. 

Overview

This cohort study compared two risk stratification approaches for smoldering multiple myeloma (SMM): the AQUILA trial criteria and the 2/20/20 model. Data were analyzed from two cohorts: 193 individuals identified through screening in the iStopMM study and 1,147 individuals from the DALY-CARE clinical registry. High-risk SMM was defined by disease features including monoclonal protein level, bone marrow plasma cell percentage, and free light chain ratio, with additional criteria in the AQUILA definition such as immunoparesis and immunoglobulin A isotype. The primary outcomes were the proportion of patients classified as high risk and the risk of progression requiring treatment.

The AQUILA criteria classified a larger proportion of patients as high risk in both cohorts (34% vs 8% in iStopMM; 55% vs 19% in DALY-CARE). In the clinical cohort, the 2-year progression risk for AQUILA-defined high-risk patients was 27.0% (95% CI 23.3%–30.7%), with an annual progression rate of 14.5%, compared with 44.1% (95% CI 37.1%–51.1%) and 27.3%, respectively, for those classified as high risk by the 2/20/20 model. These results show that the 2/20/20 model identifies a smaller high-risk group with higher progression rates, while the AQUILA criteria include a broader group with lower short-term progression risk.

"Implementation of a Model Program at an Independent Community Oncology Practice for the Outpatient Administration of B-Cell Maturation Antigen–Directed Bispecific Antibody Step-Up Doses"

Source

Yonatan Resnick et al. Implementation of a Model Program at an Independent Community Oncology Practice for the Outpatient Administration of B-Cell Maturation Antigen–Directed Bispecific Antibody Step-Up Doses. JCO Oncol Pract 0, OP-25-00585 DOI:10.1200/OP-25-00585  April 23, 2026. 

Overview

Manufacturer labeling for BCMA-targeting bispecific antibodies recommends inpatient hospitalization during step-up dosing to enable rapid management of cytokine release syndrome and other early adverse events — a requirement that increases costs, limits patient access particularly in rural areas, and creates logistical burdens for patients and healthcare systems. This report describes the outpatient bispecific antibody program developed at New England Cancer Specialists, an independent community oncology practice serving a large rural geography in New England.

The authors outline the operational infrastructure, staffing, monitoring protocols, and care coordination workflows built to support safe outpatient step-up dosing of teclistamab and elranatamab outside a hospital setting. The program was designed explicitly to expand access for patients who would otherwise face significant travel burdens to reach academic medical centers offering inpatient administration. Rather than reporting formal efficacy or safety outcomes from a defined patient cohort, the paper describes the structural and clinical decision-making framework the practice developed, drawing on their accumulated experience to discuss feasibility considerations and lessons applicable to other community sites. The authors also note potential to extend outpatient administration models to bispecific antibodies used in other malignancies. As bispecific antibodies move into earlier lines of myeloma therapy and patient volumes grow, community-based outpatient administration programs will become increasingly relevant to ensuring equitable access to this drug class.

"Functional high-risk phenotype predicts poor survival in multiple myeloma independent of front-line treatment: A secondary analysis of CIBMTR data"

Source

Goel U, Dragomirescu C, Zanwar S, Cassano RC, Cicero KI, Cowan AJ, et al. Functional high-risk phenotype predicts poor survival in multiple myeloma independent of front-line treatment: A secondary analysis of CIBMTR data. Br J Haematol. 2026;00:1–9. https://doi.org/10.1111/bjh.70490  April 23, 2026. 

Overview

A persistent question in myeloma is whether early post-transplant progression reflects inherently aggressive disease biology or simply inadequate frontline therapy — a distinction with implications for how functionally high-risk (FHR) disease is defined and managed. This CIBMTR analysis pooled data from three registry studies covering 853 patients who progressed within 24 months of frontline autologous transplant between 2008 and 2018, comparing outcomes in those who received standard lenalidomide-containing triplets (VRd or KRd) versus older or less intensive induction regimens.

Across all three FHR thresholds examined (progression within 12, 18, or 24 months), the type of frontline induction did not significantly influence post-relapse overall survival. In the FHR12 cohort, median OS was 21 months with VRd/KRd versus 17 months with other regimens, but the difference was not statistically significant (HR 0.94, p=0.69), and no significant interaction was found between frontline regimen type and time to relapse in predicting OS. The findings suggest that early post-transplant progression carries a poor prognosis regardless of whether the frontline regimen was optimal by contemporary standards — meaning FHR disease represents a true high-risk biological phenotype rather than an artifact of suboptimal prior treatment. The authors conclude that FHR status should prompt early consideration of T-cell redirecting therapies in the second line, independent of what induction the patient received.

"Effect of intravenous immunoglobulin on infections in multiple myeloma patients receiving daratumumab"

Source

Lancman G, Sastow D, Aslanova M, Moshier E, Cho HJ, Jagannath S, Parekh S, Richard S, Richter J, Rodriguez C, Rossi A, Sanchez L, Thibaud S, Chari A. Effect of intravenous immunoglobulin on infections in multiple myeloma patients receiving daratumumab. Haematologica; https://doi.org/10.3324/haematol.2025.289215 [Early view]. April 23, 2026. 

Overview

Daratumumab depletes CD38-expressing healthy plasma cells alongside malignant ones, leading to hypogammaglobulinemia and increased infection risk — particularly respiratory infections — that has been consistently documented in clinical trials. This single-center retrospective study examined whether intravenous immunoglobulin (IVIG) replacement meaningfully reduced infection rates in 43 myeloma patients treated with daratumumab who developed hypogammaglobulinemia, primarily in the relapsed/refractory setting. The majority (81%) had moderate hypogammaglobulinemia with IgG below 400 mg/dL.

Comparing periods of IVIG use against observation periods within the same patients, all-grade infections were 43% lower and grade 3-4 infections were 70% lower during IVIG use. A separate reference group of 100 daratumumab-treated patients who never received IVIG had lower baseline infection rates both before and during daratumumab treatment, suggesting that IVIG was selectively administered to patients with greater pre-existing infection susceptibility — an important confounder that limits direct comparison between groups. The within-patient comparison is more interpretable and shows a substantial reduction in severe infections during IVIG periods. The findings support IVIG replacement as a clinically meaningful intervention for daratumumab-treated patients with recurrent infections and hypogammaglobulinemia, consistent with the broader evidence base that has since led many centers to adopt IgG monitoring and prophylactic IVIG as standard supportive care in this setting.

"Access to Bispecific Therapies for Multiple Myeloma: An Overview of Barriers and Emerging Solutions"

Source

Emmanuel Ekpenyong, Maryam Mohsin, Samer Al Hadidi, Sarvari V Yellapragada, Access to Bispecific Therapies for Multiple Myeloma: An Overview of Barriers and Emerging Solutions, Clinical Lymphoma Myeloma and Leukemia, 2026, ISSN 2152-2650, https://doi.org/10.1016/j.clml.2026.04.010. April 23, 2026. 

Overview

Bispecific T-cell engagers have produced response rates and survival outcomes in relapsed/refractory myeloma that represent a meaningful advance over prior standard-of-care options, but clinical efficacy in trials does not automatically translate into equitable access in practice. This review maps the barriers preventing patients from receiving bispecific antibody therapy in real-world settings, organized across geographic, socioeconomic, patient-level, and health system-level domains.

The specific barriers and proposed mitigation strategies are not detailed in the provided abstract, but the framing reflects a well-documented pattern in myeloma: survival disparities by race, income, insurance status, and geography predate bispecific antibodies and are likely to persist or widen as high-cost, administratively complex therapies requiring step-up dosing and specialized monitoring become more central to treatment. The review's focus on evidence-based access strategies suggests it moves beyond problem description toward actionable recommendations — an important distinction given that access barriers in myeloma have been characterized extensively without producing proportionate changes in practice or policy. The outpatient administration models being developed at community oncology practices represent one practical response to geographic and health system barriers, and the review likely addresses similar structural interventions alongside patient-level and financial considerations.

"Decreased Expression of FAT4 Promotes Multiple Myeloma Proliferation and Migration by Targeting the Hippo/YAP Pathway"

Source

L.Zhang, N.Shen, X.Cheng, Q.Shi, L.Chen, and X.Shen, “Decreased Expression of FAT4 Promotes Multiple Myeloma Proliferation and Migration by Targeting the Hippo/YAP Pathway,” Cancer Science (2026): 1–11, https://doi.org/10.1111/cas.70404.  April 23, 2026. 

Overview

FAT4, a member of the protocadherin family of cell adhesion molecules, has been implicated as a tumor suppressor in several cancers, but its role in myeloma has not been characterized. This study identified FAT4 as the sixth most frequently mutated gene in newly diagnosed myeloma through targeted sequencing of 161 patient samples, with a mutation frequency of 15.5%. FAT4 mutations correlated with reduced FAT4 expression and poor prognosis.

In vitro knockdown of FAT4 promoted myeloma cell proliferation and migration, and these findings were confirmed in zebrafish and mouse models. Mechanistically, FAT4 loss activated the Hippo/YAP pathway — a signaling axis involved in cell growth and survival across multiple cancer types — but through an unconventional mechanism. Rather than operating through the canonical phosphorylation cascade that typically regulates YAP nuclear entry, FAT4 protein directly bound YAP and physically retained it in the cytoplasm, preventing nuclear translocation and downstream transcriptional activity. Loss of FAT4 disrupted this interaction, freeing YAP to enter the nucleus and drive pro-tumorigenic gene expression. The identification of FAT4 as a frequently mutated tumor suppressor in myeloma and the characterization of its non-canonical YAP-retention mechanism add a new layer to the understanding of Hippo pathway dysregulation in this disease and suggest FAT4-YAP interaction as a potential therapeutic target for further investigation.

"Isatuximab: an anti-CD38 therapy that addresses unmet needs and mechanisms of resistance in multiple myeloma"

Source

Liu, Y., Mo, C., Midha, S., Hartley-Brown, M., Lee, H. C., Franz, J., … Richardson, P. G. (2026). Isatuximab: an anti-CD38 therapy that addresses unmet needs and mechanisms of resistance in multiple myeloma. Expert Opinion on Investigational Drugs. https://doi.org/10.1080/13543784.2026.2660911 April 23, 2026.  

Overview

This review examines isatuximab's mechanism of action and its differentiation from other anti-CD38 antibodies, particularly daratumumab, across the myeloma treatment continuum. While both agents target CD38, isatuximab elicits antitumor activity through multiple pathways and is distinguished by a direct cytotoxic mechanism — including direct apoptosis induction — that daratumumab does not share to the same degree. Isatuximab relies only partly on complement-dependent cytotoxicity (CDC), which the authors argue may be clinically relevant: CDC activity can be impaired in patients with 1q21 amplification and extramedullary disease, two high-risk features associated with poor outcomes, and reduced CDC dependence may therefore translate into more consistent activity in these difficult-to-treat subgroups.

The review also covers isatuximab's approved indications across newly diagnosed and relapsed/refractory myeloma, supporting clinical data across broad patient populations, and the addition of the on-body injector as a subcutaneous delivery option. The mechanistic differentiation argument — that isatuximab's direct cytotoxic pathways provide a clinical advantage in specific high-risk contexts — is the review's central thesis, though head-to-head comparative data between isatuximab and daratumumab in these subgroups remain limited. The expert opinion framing reflects that some of the differentiation claims rest on preclinical data and indirect clinical evidence rather than randomized comparisons.

"Hypoalbuminemia in MGUS: interpreting a prognostic signal within its biological context"

Source

Bibas, M. Hypoalbuminemia in MGUS: interpreting a prognostic signal within its biological context. Blood Cancer J. 16, 63 (2026). https://doi.org/10.1038/s41408-026-01490-2 April 24, 2026. 

Overview

This letter responds to a study by Alejo et al. reporting that serum albumin ≤3.5 g/dL at MGUS diagnosis is associated with increased progression risk to myeloma or related plasma cell disorders. The correspondents accept the prognostic finding but argue that its interpretation requires careful contextualization: serum albumin is a negative acute-phase reactant shaped by systemic inflammation, vascular permeability, hepatic synthetic capacity, and nutritional status, making it a broad marker of host vulnerability rather than a plasma cell-specific readout. In the original cohort, hypoalbuminemic patients were older and had higher creatinine and lower hemoglobin — a pattern more consistent with chronic kidney disease, frailty, and inflammation-related anemia than with clonal plasma cell activity alone.

The letter makes the conceptually important point that biological non-specificity and prognostic relevance are not mutually exclusive. Systemic inflammation, immunosenescence, and frailty — whether driven by MGUS or by parallel age-related processes including CHIP — may influence clonal evolution through shared mechanisms such as cytokine-mediated bone marrow microenvironment remodeling and impaired immune surveillance. Albumin may function as a composite surrogate for this intersection of host vulnerability and clonal biology, particularly in intermediate-risk MGUS where moderate clonal burden and systemic physiological decline converge. The correspondents also raise methodological concerns: the hypoalbuminemic subgroup had few progression events, yielding wide confidence intervals; a single baseline albumin measurement cannot distinguish persistent vulnerability from transient perturbation; and the absence of longitudinal albumin data or correlative bone marrow microenvironment analyses limits causal inference. They recommend future studies incorporate validated frailty measures, serial albumin tracking, and inflammatory mediator profiling alongside clonal parameters to determine whether albumin adds prognostic information beyond comprehensive host-adjusted risk models.

"Socioeconomic Disparities in Multiple Myeloma Survival in New South Wales Australia: A Population-Based Cohort Study"

Source

Yu XQ, Zhang H, Luo Q, et al. Socioeconomic Disparities in Multiple Myeloma Survival in New South Wales Australia: A Population-Based Cohort Study. Cancer Control. 2026;33. doi:10.1177/10732748261438543 April 24, 2026. 

Overview

This letter responds to a study by Alejo et al. reporting that serum albumin ≤3.5 g/dL at MGUS diagnosis is associated with increased progression risk to myeloma or related plasma cell disorders. The correspondents accept the prognostic finding but argue that its interpretation requires careful contextualization: serum albumin is a negative acute-phase reactant shaped by systemic inflammation, vascular permeability, hepatic synthetic capacity, and nutritional status, making it a broad marker of host vulnerability rather than a plasma cell-specific readout. In the original cohort, hypoalbuminemic patients were older and had higher creatinine and lower hemoglobin — a pattern more consistent with chronic kidney disease, frailty, and inflammation-related anemia than with clonal plasma cell activity alone.

The letter makes the conceptually important point that biological non-specificity and prognostic relevance are not mutually exclusive. Systemic inflammation, immunosenescence, and frailty — whether driven by MGUS or by parallel age-related processes including CHIP — may influence clonal evolution through shared mechanisms such as cytokine-mediated bone marrow microenvironment remodeling and impaired immune surveillance. Albumin may function as a composite surrogate for this intersection of host vulnerability and clonal biology, particularly in intermediate-risk MGUS where moderate clonal burden and systemic physiological decline converge. The correspondents also raise methodological concerns: the hypoalbuminemic subgroup had few progression events, yielding wide confidence intervals; a single baseline albumin measurement cannot distinguish persistent vulnerability from transient perturbation; and the absence of longitudinal albumin data or correlative bone marrow microenvironment analyses limits causal inference. They recommend future studies incorporate validated frailty measures, serial albumin tracking, and inflammatory mediator profiling alongside clonal parameters to determine whether albumin adds prognostic information beyond comprehensive host-adjusted risk models.

"The clinical utility of the HFA–ICOS risk proforma for predicting heart failure hospitalization in a real-world cohort of multiple myeloma patients"

Source

Ho, M.H., Leung, C., Leung, C.Y. et al. The clinical utility of the HFA–ICOS risk proforma for predicting heart failure hospitalization in a real-world cohort of multiple myeloma patients. BMC Cardiovasc Disord (2026). https://doi.org/10.1186/s12872-026-05895-6 April 25, 2026

Overview

Cardiovascular toxicity from proteasome inhibitors and immunomodulatory agents is a recognized concern in myeloma treatment, but prospective cardiovascular risk stratification is rarely implemented in routine myeloma care. This retrospective study from Queen Elizabeth Hospital in Hong Kong applied the HFA-ICOS cardiovascular risk proforma — a structured tool developed jointly by the Heart Failure Association of the European Society of Cardiology and the International Cardio-Oncology Society — to 419 consecutive myeloma patients treated between 2012 and 2023.

Patients stratified into low, medium, and high/very-high risk groups showed markedly different three-year cumulative incidences of heart failure hospitalization: 4.3%, 11.1%, and 28.3% respectively (p<0.001). CV mortality followed a similar gradient at 1.4%, 5.1%, and 11.8%, though the trend did not reach statistical significance for mortality (p=0.084). In multivariable analysis, prior heart failure (SHR 3.96), chronic kidney disease (SHR 4.34), atrial fibrillation (SHR 2.30), and advanced age (SHR 1.03 per year) were the strongest independent predictors of heart failure hospitalization. The proforma achieved a C-statistic of 0.706, indicating moderate discriminatory ability. The findings support incorporating structured cardiovascular risk assessment using the HFA-ICOS proforma into myeloma treatment planning — particularly as patients live longer on treatment regimens that carry cumulative cardiovascular burden — to identify those warranting closer cardiology involvement or modified treatment approaches before cardiac events occur.

"A Survey Study of Patient-Physician Communication and Treatment Decision-Making Preference at Treatment Initiation and After Disease Stabilization in Newly Diagnosed Multiple Myeloma"

Source

HH.Hanamoto, M.Iino, K.Joko, et al. “A Survey Study of Patient-Physician Communication and Treatment Decision-Making Preference at Treatment Initiation and After Disease Stabilization in Newly Diagnosed Multiple Myeloma.” eJHaem7, no. 2 (2026): e70247. https://doi.org/10.1002/jha2.70247 April 26, 2026. 

Overview

This observational survey study from Japan captured communication patterns between 220 transplant-ineligible newly diagnosed myeloma patients and 120 treating hematologists, surveyed between September and November 2024. The most striking finding is a consistent gap between physician self-report and patient experience: 82.5% of physicians reported presenting treatment options at treatment initiation, while only 45.9% of patients reported having options presented or explained to them. A similar discrepancy appeared for preference elicitation — 67.5% of physicians reported asking about patient preferences, compared to 23.6% of patients who recalled being asked.

The gap in shared decision-making was equally pronounced. While 44.5% of patients preferred a shared role in treatment decisions, only 21.8% experienced one in practice at treatment initiation. Patient emotions shifted from predominantly negative at diagnosis toward more positive at disease stabilization, and disease knowledge and treatment expectations also evolved over time — findings that underscore the importance of communication not only at diagnosis but as an ongoing process throughout the treatment course. The physician-patient perception discrepancy identified here is a well-documented phenomenon in oncology more broadly, but its documentation in the Japanese myeloma context is useful given Japan's distinct medical communication culture. The authors conclude that physicians should account for how patients' emotional state, knowledge, and expectations change between diagnosis and stabilization, and adjust their communication approach accordingly rather than treating initial information-giving as sufficient

"Non-ICANS Neurologic Events in Patients With Relapsed/Refractory Multiple Myeloma Treated With Ciltacabtagene Autoleucel: Clinical Presentation and Management in CARTITUDE Studies"

Source

Nitin Patel, Adam D. Cohen, Bianca D. Santomasso, Non-ICANS Neurologic Events in Patients With Relapsed/Refractory Multiple Myeloma Treated With Ciltacabtagene Autoleucel: Clinical Presentation and Management in CARTITUDE Studies, Clinical Lymphoma Myeloma and Leukemia, 2026, ISSN 2152-2650, https://doi.org/10.1016/j.clml.2026.04.013. April 27, 2026.

Overview

This review summarizes non-ICANS neurologic toxicity data from the CARTITUDE trials of cilta-cel in over 300 relapsed/refractory myeloma patients, focusing on two distinct syndromes: cranial nerve palsy (CNP) and IEC-parkinsonism (also termed movement and neurocognitive toxicity). CNP occurred in 6.3% of patients overall, with notably higher incidence in less heavily pretreated patients (9% in those with 1–3 prior lines versus 3% in those with ≥3 prior lines). Median onset was day 22 post-infusion, most cases were low grade, and 90% resolved completely. IEC-parkinsonism — involving motor, cognitive, and personality changes — showed the opposite pattern by prior treatment burden, occurring in 6% of more heavily pretreated patients versus 1% in those with fewer prior lines, with a median onset of 56 days post-infusion.

High CAR-T cell expansion is associated with increased risk of both syndromes, and absolute lymphocyte count (ALC) between days 10–28 correlates strongly with circulating CAR-T cell levels — raising the possibility of using ALC as an early surrogate to identify patients at heightened neurologic risk before symptoms develop. Prophylactic short-course steroids triggered by elevated ALC are under active investigation. The review emphasizes that earlier recognition and more aggressive intervention appear to improve outcomes for IEC-parkinsonism, which can otherwise progress insidiously. Given that many patients receive follow-up care at community oncology practices or neurology offices distant from their CAR-T infusion center, the authors identify education of local clinicians, patients, and caregivers as essential to ensure timely recognition and referral when these delayed neurologic events emerge.

"Performance and additional benefits of MALDI-TOF-MS in M-protein detection in plasma cell disorders"

Source

Dong, M., Ye, H., Xiao, X., Li, F., Yan, H., Chen, J., … Cai, Z. (2026). Performance and additional benefits of MALDI-TOF-MS in M-protein detection in plasma cell disorders. Annals of Medicine, 58(1). https://doi.org/10.1080/07853890.2026.2654933 April 27, 2026. 

Overview

Standard M-protein detection methods — serum protein electrophoresis, immunofixation electrophoresis, and serum free light chains — have well-recognized sensitivity limitations, particularly at low M-protein concentrations relevant to MRD assessment. This study evaluated matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF-MS) in 137 newly diagnosed plasma cell disorder patients, predominantly myeloma (84.7%), comparing its M-protein detection rate against conventional methods.

Serum-based MALDI-TOF-MS achieved a detection rate of 98.5%, substantially higher than SPEP (75.9%), serum IFE (86.9%), serum free light chains (71.5%), and urine IFE (76.0%). Sensitivity varied by immunoglobulin class: 93.5% for IgG and 65.5% for IgA, with light chain sensitivity of 75.8% for kappa and 80.0% for lambda. Beyond detection, MALDI-TOF-MS identified light chain glycosylation in 17 patients and other post-translational modifications in 4 — a capability conventional electrophoresis methods lack entirely. In a small subset of post-treatment samples, disappearance of glycosylation peaks correlated with complete response while persistence correlated with a shallower response, suggesting these modifications may carry information beyond simple M-protein quantification. The cohort is small and the response correlation data preliminary, but the overall detection rate advantage and the ability to characterize M-protein modifications position MALDI-TOF-MS as a potentially valuable complementary tool for both diagnosis and treatment monitoring in plasma cell disorders.

"Plain language summary of a study on 30-minute intravenous infusion of isatuximab in people with newly diagnosed multiple myeloma"

Source

Ocio, E. M., Perrot, A., Moreau, P., Mateos, M. V., Bringhen, S., Martínez-López, J., … San-Miguel, J. (2026). Plain language summary of a study on 30-minute intravenous infusion of isatuximab in people with newly diagnosed multiple myeloma. Future Oncology, 1–12. https://doi.org/10.1080/14796694.2026.2652723 April 27, 2026. 

Overview

This summary describes a study testing a faster way to give the myeloma drug isatuximab, reducing infusion time from 75 minutes to 30 minutes in patients on maintenance therapy. The results showed the shorter infusion was generally safe, with almost no infusion reactions and significant time savings for patients and healthcare providers. Overall, the researchers concluded that this faster method could make treatment more convenient without compromising safety.

"Prospective head-to-head comparison of [18F]FDG and [⁶⁸Ga]Ga-PSMA-11 PET/CT in newly diagnosed multiple myeloma"

Source

Bezzi, D., Di Franco, M., Talarico, M. et al. Prospective head-to-head comparison of [18F]FDG and [⁶⁸Ga]Ga-PSMA-11 PET/CT in newly diagnosed multiple myeloma. Eur J Nucl Med Mol Imaging (2026). https://doi.org/10.1007/s00259-026-07891-6 April 27, 2026. 

Overview

This prospective study compared [18F]FDG PET/CT and [68Ga]Ga-PSMA-11 PET/CT in 51 patients with newly diagnosed multiple myeloma scanned within 14 days. Image review was performed by two nuclear medicine physicians, with analyses at the patient and lesion levels for focal lesions, paraskeletal disease, and bone marrow involvement. Patient-level concordance was moderate (κ=0.571; 78%), with 11 discordant cases, most of which were FDG-positive/PSMA-negative (9 vs 2). For focal lesions, FDG showed higher patient-level positivity (51% vs 39%) with substantial agreement (κ=0.687). At the lesion level (154 lesions), 82 were FDG-positive only, 38 PSMA-positive only, and 34 positive on both modalities (κ=−0.51).

FDG detected more lesions in thoracic and spinal sites, while PSMA identified additional lesions in craniofacial regions. Diffuse bone marrow uptake was more frequent with FDG (29% vs 14%) and correlated with higher marrow plasma cell infiltration. Paraskeletal lesions were infrequent (n=13) but showed concordance, with all FDG-positive and 12 of 13 PSMA-positive. In concordant lesions, FDG demonstrated higher uptake intensity (median SUVmax 4.8 vs 3.5). Only a minority of PSMA-positive patients had lesion-to-liver ratios above 1. These findings indicate higher sensitivity of FDG PET/CT for baseline bone disease detection, with PSMA PET/CT providing additional site-specific information.

"Sarcopenia Evaluation in Multiple Myeloma Patients Before and After Autologous Stem Cell Transplantation: A Prospective Study"

Source

Erdogan Yucel, Elcin, Ozsan, Guner Hayri, Ozturk, Caner, Togay, Alper, Batra, Lalit, Kakcı, Merve, Seker, Omer, Altay, Canan, Alacacioglu, Inci, Sarcopenia Evaluation in Multiple Myeloma Patients Before and After Autologous Stem Cell Transplantation: A Prospective Study, European Journal of Cancer Care, 2026, 3378936, 9 pages, 2026. https://doi.org/10.1155/ecc/3378936 April 27, 2026. 

Overview

This prospective study assessed sarcopenia in 102 adults with multiple myeloma before and after autologous stem cell transplantation (ASCT) using bioelectrical impedance analysis, computed tomography, and performance testing. Evaluations were conducted one month before conditioning and six months after transplant, with sarcopenia defined by EWGSOP 2018 criteria. The median follow-up was 12 months. Sarcopenia was present in 46% of patients before ASCT and 50% after ASCT (p=0.12). The proportion of patients with low skeletal muscle index (SMI) increased from 51% pre-ASCT to 56% post-ASCT (p=0.03).

Multivariable analysis identified female sex (OR 1.25; 95% CI 1.12–1.38; p=0.007), higher Hematopoietic Cell Transplantation–Specific Comorbidity Index (HCT-CI) score (OR 1.16; 95% CI 1.04–1.29; p=0.008), and lower body mass index (BMI) (OR per unit increase 0.94; 95% CI 0.88–0.99; p=0.045) as factors associated with sarcopenia. These data show a high baseline prevalence of sarcopenia in this population, no change in overall prevalence after ASCT, and a reduction in muscle mass as measured by SMI following transplant.

"Real-world incidence of severe infections in multiple myeloma patients receiving bispecific antibodies: a meta-analysis"

Source

Spataro, F., Desantis, V., Einsele, H. et al. Real-world incidence of severe infections in multiple myeloma patients receiving bispecific antibodies: a meta-analysis. Ann Hematol 105, 269 (2026). https://doi.org/10.1007/s00277-026-07026-9 April 27, 2026. 

Overview

This systematic review and meta-analysis evaluated the incidence of severe infections in patients with relapsed or refractory multiple myeloma treated with bispecific T-cell–redirecting antibodies. Ten retrospective studies including 1,373 patients were analyzed using a random-effects model. After a median follow-up of 8.3 months, the pooled rate of grade 3–4 infections was 0.25 (95% CI 0.22–0.30), with moderate heterogeneity (I²=52.9%). Subgroup analyses showed similar rates for teclistamab (0.26; 95% CI 0.22–0.31) and talquetamab (0.23; 95% CI 0.14–0.33).

Meta-regression identified inverse associations between infection rates and both the mean number of prior therapy lines (p=0.002) and prior BCMA-directed therapy exposure (p=0.0019). Approximately one-quarter of patients experienced grade 3–4 infections during follow-up. These findings quantify infection risk in real-world settings and provide context for monitoring and supportive care strategies during bispecific antibody treatment.

"A small proportion of CD8 T cells expand robustly when stimulated with BCMAxCD3 bispecific T-cell engagers in vitro"

Source

Shibata, K., Tsutsumi, K., Murakami, H. et al. A small proportion of CD8 T cells expand robustly when stimulated with BCMAxCD3 bispecific T-cell engagers in vitro. Leukemia (2026). https://doi.org/10.1038/s41375-026-02969-4 April 27, 2026.  

Overview

This study examined which CD8 T-cell subsets drive responses to BCMA×CD3 bispecific T-cell engager therapy in multiple myeloma. In vitro co-culture experiments showed that naïve and stem cell memory (naïve/SCM) CD8 T cells had higher proliferative and cytolytic activity against myeloma cells than more differentiated (non-naïve/SCM) CD8 T cells. These findings were consistent in the absence of interleukin-2, where non-naïve/SCM subsets showed reduced expansion and killing capacity. Single-cell RNA sequencing was used to track the subsets that expanded during treatment.

During co-culture, naïve/SCM CD8 T cells differentiated into non-naïve/SCM populations, with 72.8% (±7.4%) transitioning after 8–12 days. In short-term assays using elranatamab, myeloma cell killing increased between 24 and 72 hours, and 37.9% (±7.2%) of naïve/SCM-derived cells showed early differentiation within 24 hours. These results indicate that naïve/SCM CD8 T cells initiate expansion and cytotoxic activity under BCMA×CD3 engagement and then differentiate into effector populations during the response.

"Thrombin generation profiling in multiple myeloma: a comprehensive evaluation of prothrombotic state"

Source

Miele, Ciroa; Vasco, Alessandrab; Manfredi, Lucaa,b; Randa, Immacolataa; Pepa, Roberta Dellad; Puzone, Stellaa; Addesso, Raffaellab; Di Vico, Vittoriae; Tinto, Nadiaa,b,c; Frisso, Giuliaa,b,c; Scudiero, Olgaa,b,c; Marcella, Savoiaa,b,c; Mazzaccara, Cristinaa,b,c. Thrombin generation profiling in multiple myeloma: a comprehensive evaluation of prothrombotic state. Blood Coagulation & Fibrinolysis ():10.1097/MBC.0000000000001424, April 28, 2026. | DOI: 10.1097/MBC.0000000000001424 April 28, 2026. 

Overview

This study evaluated thrombin generation in 20 patients with multiple myeloma receiving active treatment to assess hypercoagulability. Conventional coagulation tests were performed alongside thrombin generation assays (TGA) using platelet-poor plasma, with and without thrombomodulin, on the ST Genesia system. The cohort included predominantly immunoglobulin G myeloma, with smaller numbers of other subtypes.

TGA showed increased thrombin peak height (139.75%; reference 40–69%), endogenous thrombin potential (107.80%; reference 58–78%), and velocity index (153.10%; reference 31–62%), with a shortened time to peak (ratio 1.04; reference 1.2–1.5). Thrombomodulin-mediated inhibition was reduced (16.20%; reference 60–76%), indicating impaired protein C pathway activity despite normal anticoagulant levels. Additional findings included elevated fibrinogen, D-dimer, factor VIII, and von Willebrand factor. These results define a procoagulant profile in treated multiple myeloma and show that TGA detects abnormalities not captured by standard coagulation tests.

"Immune effector cell-associated enterocolitis post-BCMA directed CAR T-cell therapy: insights from a multicenter case series"

Source

Susanibar-Adaniya, S., Derman, B.A., Cohen, A.D. et al. Immune effector cell-associated enterocolitis post-BCMA directed CAR T-cell therapy: insights from a multicenter case series. Blood Cancer J. 16, 64 (2026). https://doi.org/10.1038/s41408-026-01473-3 April 28, 2026. 

Overview

This multicenter retrospective series evaluated immune effector cell–associated enterocolitis (IEC-EC) following BCMA-directed chimeric antigen receptor (CAR) T-cell therapy in relapsed or refractory multiple myeloma. Patients with unexplained diarrhea after CAR T-cell therapy underwent endoscopic evaluation after exclusion of infectious causes, with grading based on CTCAE v5.0 and ASTCT criteria. IEC-EC presented as a late-onset complication characterized by prolonged, often steroid-refractory diarrhea, frequent hospitalizations, and high treatment burden. Management included corticosteroids and additional immunosuppressive therapies, with many patients requiring total parenteral nutrition. Mortality attributable to IEC-EC was 26%, primarily due to infection or intestinal perforation rather than myeloma progression.

Pathologic and clinical findings indicated immune-mediated gastrointestinal injury with features overlapping graft-versus-host disease and immune deficiency states. Biopsies showed T-cell–predominant inflammation, requiring distinction between reactive and neoplastic processes using multimodal assessment, including T-cell receptor clonality testing. Treatment responses were variable, with some patients improving on supportive care alone and others showing limited response to immunosuppression. These data define IEC-EC as a high-morbidity toxicity of BCMA-directed CAR T-cell therapy and outline its clinical course, diagnostic approach, and management challenges in current practice.

"Targeted therapeutics and U.S. population-level mortality trends in multiple myeloma: A SEER-based analysis from 1975 to 2023"

Source

Kahlon N., Bansal N., Baddam S., Rajput J., Qureshi Z. Targeted therapeutics and U.S. population-level mortality trends in multiple myeloma: A SEER-based analysis from 1975 to 2023. Oncotarget. 2026; 17: 216-225. https://doi.org/10.18632/oncotarget.28877  April 28, 2026.  

Overview

This retrospective cross-sectional analysis used SEER data (1975–2023) to evaluate multiple myeloma–specific mortality trends in relation to treatment developments. Age-adjusted mortality rates and annual percent change (APC) were estimated using Joinpoint regression. Mortality increased from 1975 to 1994 (APC 1.43%; P<.01), declined from 1994 to 2002 (–0.70%; P=0.02), and decreased more rapidly from 2002 to 2009 (–1.85%; P<.01). Rates were stable from 2009 to 2014 (0.52%; P=0.10), followed by further declines from 2014 to 2021 (–1.73%; P<.01) and a larger reduction from 2021 to 2023 (–5.64%; P<.01).

Temporal changes in mortality correspond to the introduction of stem cell transplantation, proteasome inhibitors, immunomodulatory drugs, and more recent immune-based therapies such as CAR T-cell therapy and bispecific antibodies. These data show population-level reductions in mortality over time alongside shifts in treatment approaches, with recent periods showing larger declines following the adoption of newer therapies.

"Vestibular symptoms after talquetamab therapy in heavily pretreated multiple myeloma"

Source

James Di Palma-Grisi, Noa Biran, Pooja Phull, David Vesole, David Siegel, Harsh Parmar; Vestibular symptoms after talquetamab therapy in heavily pretreated multiple myeloma. Blood Adv 2026; 10 (8): 2626–2628. doi: https://doi.org/10.1182/bloodadvances.2025018974 April 28, 2026.  

Overview

This case series describes five myeloma patients who developed vestibular and cerebellar symptoms — primarily vertigo, ataxia, blurred vision, and gait instability — during talquetamab therapy at a single center. All five had heavily pretreated disease, most were penta-exposed, and all developed grade 1 cytokine release syndrome during step-up dosing. Neurologic symptoms emerged between cycle 2 and cycle 7, MRI results were negative for acute intracranial pathology in all cases, and cerebrospinal fluid analysis where performed was unremarkable. The dose-dependent nature of the toxicity was illustrated most clearly in case 2, where symptoms resolved with dose reduction, recurred on re-escalation to full dose, and improved again with re-reduction.

The authors estimate an incidence of 15–20% in their talquetamab monotherapy population — substantially higher than reported in clinical trials — and attribute this likely to more systematic symptom capture and longer follow-up in routine practice. The mechanism remains unclear. GPRC5D expression is low or absent in most tissues, and the related receptor GPRC5B rather than GPRC5D is more highly expressed in pontine nuclei in murine models, leaving the biological basis for vestibular toxicity unresolved. Paraneoplastic etiology was considered but no supporting features were present in any patient. Dose reduction led to symptom improvement in most cases, and one patient managed residual episodic vertigo with meclizine. The series adds vestibular and cerebellar toxicity to the recognized off-tumor effect profile of talquetamab and underscores the need for prospective systematic assessment of these symptoms in ongoing and future talquetamab trials.

"Allogeneic versus autologous transplantation in multiple myeloma: reduced relapse at the cost of higher non-relapse mortality in a large single-center cohort"

Source

Shiraji, T.S., Biglari, M., Barkhordar, M. et al. Allogeneic versus autologous transplantation in multiple myeloma: reduced relapse at the cost of higher non-relapse mortality in a large single-center cohort. Ann Hematol 105, 273 (2026). https://doi.org/10.1007/s00277-026-07027-8  April 29, 2026. . 

Overview

This single-center retrospective study compared long-term outcomes between autologous transplant (ASCT, n=1,226) and allogeneic transplant (allo-SCT, n=116) in 1,342 myeloma patients treated between 1992 and 2022, with a median follow-up of 101 months — one of the longer follow-up periods reported in this comparison.

Ten-year overall survival was statistically comparable between groups (59.2% for ASCT versus 64.0% for allo-SCT, p=0.38), but the mechanisms underlying survival differed substantially. Allo-SCT produced markedly superior PFS (50.6% versus 26.0%, p=0.002) and a much lower 10-year relapse incidence (32.5% versus 68.7%), consistent with a graft-versus-myeloma effect. However, this disease control advantage was offset by significantly higher non-relapse mortality with allo-SCT (23.4% versus 12.9%), reflecting transplant-related toxicity including graft-versus-host disease. The net result is equivalent overall survival despite very different relapse and toxicity profiles. Elevated LDH correlated with relapse risk and hypoalbuminemia with non-relapse mortality across the cohort. The data span three decades and predate modern quadruplet induction and T-cell redirecting therapies, limiting direct applicability to current practice. The findings nonetheless reinforce the established conclusion that allo-SCT offers durable disease control in a subset of patients but carries sufficient treatment-related mortality to restrict its use to carefully selected high-risk cases where the relapse reduction justifies the procedural risk.

"Efficacy and safety of talquetamab in relapsed/refractory multiple myeloma and renal impairment: a quaternary cancer center cohort"

Source

Ali, H.M., Mazzoni, S., Goel, U. et al. Efficacy and safety of talquetamab in relapsed/refractory multiple myeloma and renal impairment: a quaternary cancer center cohort. Blood Cancer J. 16, 65 (2026). https://doi.org/10.1038/s41408-026-01512-z  April 29, 2026. 

Overview

 Patients with myeloma and renal impairment are frequently excluded from clinical trials, leaving clinicians with limited evidence to guide treatment decisions …Patients with myeloma and renal impairment are frequently excluded from clinical trials, leaving clinicians with limited evidence to guide treatment decisions in this common and high-risk subgroup. This single-center retrospective study examined talquetamab outcomes in 36 heavily pretreated relapsed/refractory myeloma patients, 12 of whom (33.3%) had protocol-defined renal impairment (creatinine clearance <40 mL/min), including 7 with severe renal impairment and 5 on dialysis.

Safety profiles were comparable across renal function groups. CRS occurred in 66.7% of both the renal impairment and no-renal impairment cohorts, was predominantly low grade, and resolved within a median of one day. ICANS rates, infection rates, and hospitalization duration during step-up dosing were similarly balanced. The on-target off-tumor toxicities characteristic of talquetamab — dysgeusia, skin changes, and nail changes — occurred at comparable or slightly higher rates in the renal impairment group without reaching statistical significance. On the efficacy side, response rates were not attenuated by renal impairment: day-90 ORR was 66.7% in the renal impairment cohort versus 25% in the no-renal impairment group, and dialysis-dependent patients achieved an 80% ORR by day 90 with no progressive disease observed at that timepoint. Median PFS was significantly longer in the renal impairment cohort (8.48 versus 2.63 months, p=0.006), though the authors note that higher-risk cytogenetics in the no-renal impairment group and differences in follow-up duration complicate direct comparison. The findings support considering talquetamab for appropriately selected myeloma patients with renal impairment, including those on dialysis, provided multidisciplinary supportive care is available — a meaningful addition to a literature that has largely excluded this population.

"Talquetamab, a GPRC5D×CD3 bispecific antibody, in Chinese patients with relapsed/refractory multiple myeloma: efficacy and safety from the phase 1/2 MonumenTAL-1 study"

Source

An G, Jin J, Cai Z, Jing H, Fu C, He P, Xia Z, Liu R, Li L, Gai X, Zhang H, Zhu D, Luo X, Sun B, Xu H, Zhou L, Campagna M, Masterson TJ, Lau BW, Renaud T, Heuck C, Singh I, Vishwamitra D, Qiu L. Talquetamab, a GPRC5D×CD3 bispecific antibody, in Chinese patients with relapsed/refractory multiple myeloma: efficacy and safety from the phase 1/2 MonumenTAL-1 study. Haematologica 2026;111(4):1411-1416; https://doi.org/10.3324/haematol.2025.287334. April 2026. 

Overview

This report presents the first talquetamab efficacy and safety data from Chinese patients, enrolled as a separate phase 2 cohort within the global MonumenTAL-1 trial between February 2022 and September 2023. Twenty-nine patients received the 0.4 mg/kg weekly schedule and 12 received the 0.8 mg/kg every-two-weeks schedule, all with at least three prior lines of therapy including a proteasome inhibitor, immunomodulatory drug, and anti-CD38 antibody. ORRs of 69.0% and 66.7% in the two cohorts respectively were consistent with global MonumenTAL-1 results, as were rates of VGPR or better (58.6% and 58.3%). Median duration of response was 15.7 months in the weekly cohort and not reached in the biweekly cohort. Patients with extramedullary disease had substantially lower response rates (33.3% in the weekly cohort), consistent with the global experience.

The safety profile was broadly similar to the global cohort, with some notable differences. CRS rates were slightly higher in the China cohort (83–90% versus 73–79% globally), though predominantly grade 1/2. Taste-related adverse events occurred in 25–41% of Chinese patients versus 71–72% in the global cohort — a difference the authors acknowledge is unexplained and under further investigation. Grade 3/4 infection rates in the weekly cohort (51.7%) were substantially higher than the global weekly cohort (20.3%), which the authors attribute to enrollment coinciding with the peak of the COVID-19 pandemic in China in 2022–2023 rather than a drug-specific difference; the biweekly cohort's infection rates aligned with global data. Anti-talquetamab antibodies developed in roughly a third to half of evaluable patients but had no apparent impact on pharmacokinetics, safety, or efficacy.

"Clinical outcomes with ciltacabtagene autoleucel among patients with relapsed/refractory multiple myeloma after four or more prior lines of therapy overall and among subgroups based on age, frailty, and CRAB symptoms"

Source

An G, Jin J, Cai Z, Jing H, Fu C, He P, Xia Z, Liu R, Li L, Gai X, Zhang H, Zhu D, Luo X, Sun B, Xu H, Zhou L, Campagna M, Hansen, D. K., Castaneda Puglianini, O. A., Grajales-Cruz, A., Nagar, S. P., Ghosh, S., Fan, L., … Janakiram, M. (2026). Clinical outcomes with ciltacabtagene autoleucel among patients with relapsed/refractory multiple myeloma after four or more prior lines of therapy overall and among subgroups based on age, frailty, and CRAB symptoms. Current Medical Research and Opinion, 1–9. https://doi.org/10.1080/03007995.2026.2660494  April 30, 2026. 

Overview

This retrospective real-world study used Loopback Analytics electronic medical records to evaluate cilta-cel outcomes in 203 relapsed/refractory myeloma patients who received the therapy after four or more prior lines of treatment between February 2021 and June 2025. The cohort included populations often underrepresented in trials: 8.4% were aged 75 or older, 14.8% had mild-to-severe frailty based on a pre-infusion frailty index, and 38.4% had at least one CRAB symptom in the month before infusion.

At a median follow-up of 17.6 months, 12- and 18-month treatment-free interval rates — used as a surrogate for progression-free survival — were 85.5% and 76.5% respectively, while 12- and 18-month overall survival rates were 95.1% and 93.0%. Across the three higher-risk subgroups — older age, frailty, and recent CRAB symptoms — outcomes remained broadly consistent with the overall population, with OS staying high across all groups. The consistency of outcomes across these subgroups is clinically meaningful: frailty and active disease burden (reflected by CRAB symptoms) are common reasons clinicians hesitate to refer patients for CAR-T therapy, and these data suggest that carefully selected patients with these characteristics can achieve durable responses and favorable survival in routine practice. The treatment-free interval methodology, which requires at least two fills of a subsequent agent starting 60 or more days post-infusion, provides a pragmatic and conservative real-world approximation of disease control duration.

"Demographic and regional trends in all-cause mortality among adults with coexisting multiple myeloma and cardiovascular disease in the United States"

Source

R. Noor, T. Asghar, S. Ali, S. Iftikhar, S.M.A. Akbar, M. Qadri, B. Ahmad, V. Prakash, Demographic and regional trends in all-cause mortality among adults with coexisting multiple myeloma and cardiovascular disease in the United States, 1999–2023: A CDC WONDER analysis, Medicina de Familia. SEMERGEN, Volume 52, Issue 3, 2026, 102716, ISSN 1138-3593, https://doi.org/10.1016/j.semerg.2026.102716. April 2026. 

Overview

This study analyzed national mortality trends among adults aged ≥35 years with coexisting multiple myeloma and cardiovascular disease in the United States from 1999 to 2023 using CDC WONDER data (ICD-10 codes C90.0 and I00–I79). Crude and age-adjusted mortality rates were calculated per 100,000 population, with temporal trends assessed using Joinpoint regression. A total of 116,821 deaths were recorded. Age-adjusted mortality showed a slight overall decline (AAPC −0.05%; 95% CI −0.28 to 0.24), with a transient increase between 2018 and 2021.

Stratified analyses showed higher mortality rates among men, older adults, non-Hispanic White individuals, and residents of the Western United States and small to medium metropolitan areas. Among cardiovascular subtypes, hypertensive disease had the highest mortality rates and showed a consistent increase over time. These results describe temporal trends and subgroup differences in mortality among patients with both conditions.

"The impact of socioeconomic status on clinical presentation of multiple myeloma"

Source

Lívia Pessôa de Sant'Anna Coelho, Renata Lyrio Rafael Baptista, Gustavo de Almeida Buarque Bretas, Ana Carolina Araujo, Andrea Ribeiro Soares, The impact of socioeconomic status on clinical presentation of multiple myeloma, Hematology, Transfusion and Cell Therapy, Volume 48, Issue 2, 2026, 106256, ISSN 2531-1379, https://doi.org/10.1016/j.htct.2026.106256. April-June 2026.   

Overview

This ambispective study evaluated the association between socioeconomic status and clinical characteristics at diagnosis in 296 patients with multiple myeloma treated between 2015 and 2023 at three institutions in Rio de Janeiro, Brazil. Socioeconomic status was assessed using a questionnaire capturing education, occupation, and household income, supplemented by medical record data.

Lower socioeconomic status was associated with delayed diagnosis, higher symptom burden at presentation, more advanced disease stage, poorer performance status, lower hemoglobin levels, and higher calcium levels. These findings describe differences in disease presentation across socioeconomic groups within this cohort.

"The diagnostic utility and frequency of CD56 expression in plasma cell myeloma"

Source

Midori Imai, Asami Nishikori, Tomoka Haratake, Midori Filiz Nishimura, Rio Yamada, Syoma Kato, Mizuha Tabe, Hiroyuki Yanai, Hidetaka Yamamoto, Yasuharu Sato, The diagnostic utility and frequency of CD56 expression in plasma cell myeloma, Annals of Diagnostic Pathology, Volume 81, 2026, 152587, ISSN 1092-9134, https://doi.org/10.1016/j.anndiagpath.2025.152587. April 2026.  

Overview

This retrospective study evaluated the diagnostic utility of CD56 expression in plasma cell myeloma using bone marrow samples from 116 patients. Immunohistochemical staining included CD138, CD56, CD79a, cyclin D1, and immunoglobulin light chains (Igκ, Igλ). CD56 expression was detected in 73.3% of cases (85/116), compared with 39.7% for CD79a and 36.2% for cyclin D1 (both p<0.001). Light chain assessment was limited in a subset of cases due to technical factors.

Combination analysis showed the highest detection rate with CD56 plus CD79a (90.5%; 105/116), compared with CD56 plus cyclin D1 (80.2%) and CD79a plus cyclin D1 (64.7%) (both p<0.001). CD56 and cyclin D1 expression were absent in lymphoplasmacytic lymphoma and marginal zone lymphoma. In cases without detectable light chain restriction (9.5%), all were classified as plasma cell myeloma based on marker expression, with CD56 showing the highest detection rate (72.7%). These data describe the contribution of CD56 to immunophenotypic identification of plasma cell myeloma.

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