Rinsho Ketsueki. 2026;67(9):1250-1256. doi: 10.11406/rinketsu.67.1250.
ABSTRACT
Multiple myeloma is an uncurable hematologic malignancy; however, survival outcomes have improved with the introduction of proteasome inhibitors, immunomodulatory drugs, and anti-CD38 monoclonal antibodies. Autologous transplantation remains the standard therapy, and thus the treatment strategy for newly diagnosed myeloma is determined by transplant eligibility. Quadruplet first-line regimens were approved in 2025 and have become the standard of care regardless of transplant eligibility, improving clinical outcomes. Furthermore, treatment options for relapsed or refractory multiple myeloma now include bispecific antibodies targeting BCMA and GPRC5D, CAR-T cell therapy targeting BCMA, and antibody-drug conjugates, all of which have extended survival beyond conventional therapies. To maximize the efficacy of these treatments, it is essential to properly manage adverse events. This review covers adverse events associated with quadruplet regimens, including their impact on autologous peripheral blood stem cell collection, management of adverse events such as cytokine release syndrome and infections caused by bispecific antibodies, and ocular symptoms associated with BCMA antibody-drug conjugates.
PMID:42951641 | DOI:10.11406/rinketsu.67.1250