Impact of granulocyte colony-stimulating factors on cytokine release syndrome during bispecific antibody initiation in relapsed/refractory multiple myeloma
- 1Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY USA
- 2Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY USA
- 3Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY USA
Abstract
Bispecific antibody (BsAb) treatment in multiple myeloma can be associated with adverse events including cytokine release syndrome (CRS), cytopenias, and infections. While granulocyte colony-stimulating factors (G-CSF) can be used to treat neutropenia, little is known about their safety during the BsAb initiation period and whether G-CSF can increase the risk of CRS. To assess the impact of G-CSF on risk of CRS, we included all patients with multiple myeloma who received at least one dose (step-up doses [SUD] and first treatment dose [FTD]), of commercial teclistamab, elranatamab, or talquetamab between November 2022 and April 2024 at Memorial Sloan Kettering Cancer Center (N = 186). Exposure to G-CSF was defined as administration of at least one dose of filgrastim from 48 h before up to 7 days after BsAb SUD or FTD, or one dose of peg-filgrastim between 7 days prior to up to 7 days after BsAb SUD or FTD. Of the 186 patients, 22 were classified as G-CSF exposed. CRS occurred in 16/22 (73%) patients with G-CSF exposure vs 76/164 (46%) of non-exposed. All CRS was grade 1 (56%) or grade 2 (44%) and the majority occurred prior to G-CSF was given (16/22 patients). The median absolute neutrophil count (ANC) at time of G-CSF exposure was 0.5 × 109/L (0.4–0.7). There was a trend towards increased risk of CRS after G-CSF exposure, although not significant (hazard ratio [HR] 1.7, 95% confidence interval [CI] 0.6–4.7, p = 0.3). These results suggest that G-CSF administration can be considered for neutropenia during BsAb initiation.
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BibTeX
@article{wang2026impact,
title = {{Impact of granulocyte colony-stimulating factors on cytokine release syndrome during bispecific antibody initiation in relapsed/refractory multiple myeloma}},
author = {Alice X. Wang and Tala Shekarkhand and David Nemirovsky and Andriy Derkach and Carlyn R. Tan and Issam S. Hamadeh and Ross S. Firestone and Eric Jurgens and Kevin Miller and Dhwani Patel and Neha Korde and Alexander M. Lesokhin and Sham Mailankody and Hani Hassoun and Hamza Hashmi and Sridevi Rajeeve and Urvi A. Shah and Kylee Maclachlan and Gunjan L. Shah and Michael Scordo and Heather J. Landau and Sergio A. Giralt and Saad Z. Usmani and Malin Hultcrantz},
journal = {Blood Cancer Journal},
year = {2026},
month = aug,
doi = {10.1038/s41408-026-01594-9},
url = {https://doi.org/10.1038/s41408-026-01594-9},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Impact of granulocyte colony-stimulating factors on cytokine release syndrome during bispecific antibody initiation in relapsed/refractory multiple myeloma
AU - Alice X. Wang
AU - Tala Shekarkhand
AU - David Nemirovsky
AU - Andriy Derkach
AU - Carlyn R. Tan
AU - Issam S. Hamadeh
AU - Ross S. Firestone
AU - Eric Jurgens
AU - Kevin Miller
AU - Dhwani Patel
AU - Neha Korde
AU - Alexander M. Lesokhin
AU - Sham Mailankody
AU - Hani Hassoun
AU - Hamza Hashmi
AU - Sridevi Rajeeve
AU - Urvi A. Shah
AU - Kylee Maclachlan
AU - Gunjan L. Shah
AU - Michael Scordo
AU - Heather J. Landau
AU - Sergio A. Giralt
AU - Saad Z. Usmani
AU - Malin Hultcrantz
PY - 2026
DA - 2026/08/07
JO - Blood Cancer Journal
DO - 10.1038/s41408-026-01594-9
UR - https://doi.org/10.1038/s41408-026-01594-9
AB - Bispecific antibody (BsAb) treatment in multiple myeloma can be associated with adverse events including cytokine release syndrome (CRS), cytopenias, and infections. While granulocyte colony-stimulating factors (G-CSF) can be used to treat neutropenia, little is known about their safety during the BsAb initiation period and whether G-CSF can increase the risk of CRS. To assess the impact of G-CSF on risk of CRS, we included all patients with multiple myeloma who received at least one dose (step-up doses [SUD] and first treatment dose [FTD]), of commercial teclistamab, elranatamab, or talquetamab between November 2022 and April 2024 at Memorial Sloan Kettering Cancer Center (N = 186). Exposure to G-CSF was defined as administration of at least one dose of filgrastim from 48 h before up to 7 days after BsAb SUD or FTD, or one dose of peg-filgrastim between 7 days prior to up to 7 days after BsAb SUD or FTD. Of the 186 patients, 22 were classified as G-CSF exposed. CRS occurred in 16/22 (73%) patients with G-CSF exposure vs 76/164 (46%) of non-exposed. All CRS was grade 1 (56%) or grade 2 (44%) and the majority occurred prior to G-CSF was given (16/22 patients). The median absolute neutrophil count (ANC) at time of G-CSF exposure was 0.5 × 109/L (0.4–0.7). There was a trend towards increased risk of CRS after G-CSF exposure, although not significant (hazard ratio [HR] 1.7, 95% confidence interval [CI] 0.6–4.7, p = 0.3). These results suggest that G-CSF administration can be considered for neutropenia during BsAb initiation.
SN - 2044-5385
ER -