{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:43:04Z","timestamp":1787168584866,"version":"build-2736575974"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":300,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Hematology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Central nervous system involvement in multiple myeloma (MM\u2010CNS) is a condition with poor prognosis and no clear treatment options. Standard regimens, including proteasome inhibitors (PIs) and immunomodulatory (IMiD) agents, provide minimal benefit in this setting, highlighting the need for novel therapies. Teclistamab, a bispecific T\u2010cell engager (BiTE) targeting B\u2010cell maturation agent (BCMA) and CD3, has demonstrated robust systemic activity in heavily pretreated MM but its role in CNS disease remains undefined, as patients with CNS involvement have been excluded from pivotal trials. We present the case of a 62\u2010year\u2010old female with high\u2010risk MM who developed extensive leptomeningeal myelomatosis following multiple lines of therapy including autologous transplantation, PI\u2010 and IMiD\u2010based regimens, and palliative radiotherapy. Upon presentation with confusion, aphasia, and ataxia, MRI revealed diffuse leptomeningeal enhancement. The patient elected to proceed with teclistamab therapy. Following two cycles, she achieved a very good partial serologic response and MRI demonstrated marked radiologic improvement with resolution of cerebellar nodularity and sulcal enhancement. However, functional recovery was not observed, and the treatment was discontinued after three cycles due to clinical decline and infectious complications. She subsequently transitioned to supportive care and passed away 1\u2009month later. This case report documents one of the first reports of teclistamab demonstrating radiologic improvement in leptomeningeal disease in MM\u2010CNS. While the patient\u2019s overall outcome was poor, the observed CNS response supports the biologic plausibility of BiTE penetration and activity in the CNS. These findings suggest the urgent need for prospective studies of BCMA\u2010directed bispecific antibodies in MM\u2010CNS, as well as earlier intervention prior to functional decline.<\/jats:p>","DOI":"10.1155\/crh\/8425047","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T21:23:42Z","timestamp":1761686622000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Case Report Supporting the Use of Teclistamab in Multiple Myeloma With CNS Involvement"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7616-6925","authenticated-orcid":false,"given":"Jessica","family":"Blackman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6996-878X","authenticated-orcid":false,"given":"Justin T.","family":"Blackman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5998-4727","authenticated-orcid":false,"given":"Anvita","family":"Pauranik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9761-349X","authenticated-orcid":false,"given":"Ashley T.","family":"Freeman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,28]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/4081971"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2022-163447"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(21)01338-6"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.2147\/cmar.s372237"},{"key":"e_1_2_11_5_2","unstructured":"Janssen Research & Development LLC. A Phase 1&2 First-in-Human Open-Label Dose Escalation Study of Teclistamab A Humanized BCMA X CD3 Bispecific Antibody in Subjects With Relapsed or Refractory Multiple Myeloma 2025 https:\/\/clinicaltrials.gov\/study\/NCT04557098."},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2023-181029"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1072490"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2203478"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1181620"},{"key":"e_1_2_11_10_2","volume-title":"Safety and Efficacy of Blinatumomab in Patients With Central Nervous System (CNS) Disease: A Single Institution Experience","author":"Alfayez M."},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2024024168"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1276295"},{"key":"e_1_2_11_13_2","unstructured":"MersiJ. EiseleF. ZhouX.et al. The Role of Bispecific Antibodies and CAR T Cells in the Treatment of Multiple Myeloma With Central Nervous System Involvement European Hematology Association (EHA) 2024 Hybrid Congress June 2024."},{"key":"e_1_2_11_14_2","unstructured":"LachenalF. GeromeT. ChalopinT.et al. Effectiveness and Safety of Bispecific Antibodies Targeting BCMA and CD3 in Patients With Central Nervous System Multiple Myeloma (CNS-MM): IFM 2023-06 A Retrospective Cohort Study European Hematology Association (EHA) 2024 Hybrid Congress June 2024."}],"container-title":["Case Reports in Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crh\/8425047","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crh\/8425047","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crh\/8425047","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T15:04:32Z","timestamp":1772982272000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crh\/8425047"}},"subtitle":[],"editor":[{"given":"Kalyani","family":"Sen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1155\/crh\/8425047"],"URL":"https:\/\/doi.org\/10.1155\/crh\/8425047","archive":["Portico"],"relation":{},"ISSN":["2090-6560","2090-6579"],"issn-type":[{"value":"2090-6560","type":"print"},{"value":"2090-6579","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2025-06-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"8425047"}}