9-Year Serial CMR Monitoring of Cardiac AL Amyloidosis Regression After Teclistamab
- 1Department of Radiology and Cardiovascular Imaging, GHICL–Groupement des Hôpitaux de l’Institut Catholique de Lille, Lille, France
- 2Department of Hematology, GHICL–Groupement des Hôpitaux de l'Institut Catholique de Lille–Hôpital Saint-Vincent-de-Paul, Lille, France
Abstract
Background: Cardiac amyloid light-chain (AL) amyloidosis carries a poor prognosis and is considered largely irreversible once symptomatic. Long-term serial cardiovascular magnetic resonance (CMR) data following B-cell maturation antigen-directed therapy are lacking.
Case Summary: A 64-year-old man with biopsy-proven cardiac AL amyloidosis achieved sustained hematologic complete response after teclistamab following failure of 4 prior lines including daratumumab. Eleven CMR examinations over 9 years documented a biphasic trajectory: progressive infiltration through 2020 (left ventricular mass 186 g, wall thickness 18 mm, global longitudinal strain −4.8%), followed by sustained structural and functional regression through 2025 (left ventricular mass 127 g, wall thickness 13 mm, global longitudinal strain −13.7%).
Discussion: This represents the longest serial CMR follow-up in cardiac AL amyloidosis reported to date, demonstrating that cine-derived parameters reliably track cardiac regression in real-world conditions. Native T1 normalized while extracellular volume fraction (ECV) paradoxically increased, suggesting persistent fibril burden beyond hematologic clearance.
Take-Home Message: Serial CMR with cine-derived parameters provides robust longitudinal monitoring of cardiac AL amyloidosis regression following novel plasma cell–directed therapy, even without systematic contrast enhancement.
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- Gender and Racial Distribution of Transthyretin Stabilizer Therapy in Patients With Transthyretin Cardiac Amyloidosis.
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BibTeX
@article{silvestri20269year,
title = {{9-Year Serial CMR Monitoring of Cardiac AL Amyloidosis Regression After Teclistamab}},
author = {Valentina Silvestri and Manuel Toledano and Bénédicte Hivert and Emmanuelle Bourgeois and Benjamin Carpentier and Jean Giraud and Alexandre Willaume and François Delelis and Laurent Pascal},
journal = {JACC Case Reports},
year = {2026},
month = aug,
doi = {10.1016/j.jaccas.2026.109553},
url = {https://doi.org/10.1016/j.jaccas.2026.109553},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - 9-Year Serial CMR Monitoring of Cardiac AL Amyloidosis Regression After Teclistamab
AU - Valentina Silvestri
AU - Manuel Toledano
AU - Bénédicte Hivert
AU - Emmanuelle Bourgeois
AU - Benjamin Carpentier
AU - Jean Giraud
AU - Alexandre Willaume
AU - François Delelis
AU - Laurent Pascal
PY - 2026
DA - 2026/08/27
JO - JACC Case Reports
DO - 10.1016/j.jaccas.2026.109553
UR - https://doi.org/10.1016/j.jaccas.2026.109553
AB - Background: Cardiac amyloid light-chain (AL) amyloidosis carries a poor prognosis and is considered largely irreversible once symptomatic. Long-term serial cardiovascular magnetic resonance (CMR) data following B-cell maturation antigen-directed therapy are lacking. Case Summary: A 64-year-old man with biopsy-proven cardiac AL amyloidosis achieved sustained hematologic complete response after teclistamab following failure of 4 prior lines including daratumumab. Eleven CMR examinations over 9 years documented a biphasic trajectory: progressive infiltration through 2020 (left ventricular mass 186 g, wall thickness 18 mm, global longitudinal strain −4.8%), followed by sustained structural and functional regression through 2025 (left ventricular mass 127 g, wall thickness 13 mm, global longitudinal strain −13.7%). Discussion: This represents the longest serial CMR follow-up in cardiac AL amyloidosis reported to date, demonstrating that cine-derived parameters reliably track cardiac regression in real-world conditions. Native T1 normalized while extracellular volume fraction (ECV) paradoxically increased, suggesting persistent fibril burden beyond hematologic clearance. Take-Home Message: Serial CMR with cine-derived parameters provides robust longitudinal monitoring of cardiac AL amyloidosis regression following novel plasma cell–directed therapy, even without systematic contrast enhancement.
SN - 2666-0849
ER -