{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:07:09Z","timestamp":1792793229146,"version":"4.5.0"},"reference-count":10,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T00:00:00Z","timestamp":1720396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Teclistamab is a B\u2010cell maturation antigen (BCMA)\u2010directed bispecific T\u2010cell engager approved for relapsed\u2010refractory multiple myeloma (RRMM). Cytokine release syndrome (CRS) and Immune effector cell\u2010associated neurotoxicity syndrome (ICANS) are well\u2010documented treatment \u2010related adverse events of teclistamab. The prescribing information recommends step\u2010up dosing on days 1, 4, and 7 with 48\u201372 h of inpatient observation after each dose to monitor for CRS. This leads to a more than weeklong hospital stay, adding to the cost of therapy, resource utilization, and patient inconvenience. Here, we present a single center retrospective analysis addressing the safety and utility of a condensed step\u2010up dosing schedule for teclistamab. All patients who were treated with teclistamab from November 2022 to August 2023 at the Medical University of South Carolina were included in the analysis. Patients received subcutaneous (SC) teclistamab with step\u2010up doses (0.06 and 0.3 mg\/kg) separated by either 2 or 3 (48\u201372 h) before the administration of the first full (1.5 mg\/kg) dose (days 1, 3, and 5 \u2018condensed\u2019 schedule or days 1, 4, and 7 \u2018standard\u2019 schedule, respectively). All patients were hospitalized for the two step\u2010up doses and first full dose of teclistamab and received pre\u2010medications prior to each dose. Patients could be discharged after a minimum of 24 h following the full dose, if they did not have any CRS or ICANS. Relevant data regarding incidence, severity, and onset of CRS was collected. Statistical analysis was completed to assess the probability of fever with the first full dose of teclistamab based on incidence of fever with previous doses. A total of 25 patients were included in the analysis. Twenty\u2010eight percent (7\/25) of patients underwent the standard step up while the remaining 72% (18\/25) underwent a condensed step up of teclistamab. More than half (53%, 13\/25) of the patients experienced CRS during step up dosing. Grades 1 and 2 CRS occurred in 48% (12\/25) and 4% (1\/25) patients, respectively. Of the 13 patients that experienced CRS, 30% (4\/13) fevered with the first dose, 84% (11\/13) fevered with the second dose, and one patient developed fever after the third dose. The negative predictive value of being \u2018fever free\u2019 after doses 1 and 2 and remaining \u2018fever free\u2019 throughout hospitalization was 0.92. The median length of hospital stay among the 1, 3, and 5 step up group was 6 days (6\u201325) and 70% (14\/20) of patients were discharged from the hospital within 7 days of treatment initiation. This report demonstrates the utility of a condensed step\u2010up schedule for teclistamab initiation. The schedule was found to be safe and reduced hospital length of stay. These results should prompt consideration of shorter hospital stays for patients who do not experience CRS and raise the possibility of outpatient administration with close observation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jha2.906","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T01:55:41Z","timestamp":1720490141000},"page":"793-797","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["<i>\u201cFast but not so furious\u201d<\/i>: A condensed step\u2010up dosing schedule of teclistamab for relapsed\/refractory multiple myeloma"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7959-4529","authenticated-orcid":false,"given":"Kevin C.","family":"Graf","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Hematology\/Oncology Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7978-1652","authenticated-orcid":false,"given":"James A","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Cendagorta","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katelynn","family":"Granger","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly J.","family":"Gaffney","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology\/Oncology Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian T","family":"Hess","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology\/Oncology Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza","family":"Hashmi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology\/Oncology Medical University of South Carolina  Charleston South Carolina USA"},{"name":"Department of Medicine Multiple Myeloma service Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,8]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-019-0435-7"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2019.09.621"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2016-0104"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2203478"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02528-9"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2204591"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01338-6"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-018-0343-9"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.12.758"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408\u2010023\u201000963\u2010y"}],"container-title":["eJHaem"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jha2.906","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T02:14:03Z","timestamp":1760408043000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jha2.906"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,8]]},"references-count":10,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1002\/jha2.906"],"URL":"https:\/\/doi.org\/10.1002\/jha2.906","archive":["Portico"],"relation":{},"ISSN":["2688-6146","2688-6146"],"issn-type":[{"value":"2688-6146","type":"print"},{"value":"2688-6146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,8]]},"assertion":[{"value":"2024-01-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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