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BCMA-targeted T-cell engager therapy induces sustained remission in immune thrombocytopenia

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Item Type:Article
Title:BCMA-targeted T-cell engager therapy induces sustained remission in immune thrombocytopenia
Creators: Korenkov, Michael ORCID logoORCID: https://orcid.org/0000-0002-2988-8483, Zuleeg, Maximilian Rudolf ORCID logoORCID: https://orcid.org/0009-0002-9947-5585, Liebaert, Julian, Fregona, Vincent ORCID logoORCID: https://orcid.org/0000-0003-4857-1737, Serve, Sebastian ORCID logoORCID: https://orcid.org/0000-0002-9839-7119, Jesse, Julia, Böckle, Stephan Rainer ORCID logoORCID: https://orcid.org/0000-0002-1783-9641, Bohl, Stephan Rainer ORCID logoORCID: https://orcid.org/0000-0001-9379-3342, Damm, Frederik ORCID logoORCID: https://orcid.org/0000-0001-5553-1173, Bullinger, Ulrich ORCID logoORCID: https://orcid.org/0000-0002-5890-5510, Keller, Ulrich ORCID logoORCID: https://orcid.org/0000-0002-8485-1958, Busse, Adrian ORCID logoORCID: https://orcid.org/0000-0002-3470-6947, Schwarzer, Adrian, Albach, Fredrik ORCID logoORCID: https://orcid.org/0000-0002-2697-9080, Thiele, Thomas ORCID logoORCID: https://orcid.org/0000-0003-0177-6508, Haas, Simon ORCID logoORCID: https://orcid.org/0000-0001-9227-2051, Krönke, Jan ORCID logoORCID: https://orcid.org/0000-0002-4649-0506 and Hütter-Krönke, Marie Luise ORCID logoORCID: https://orcid.org/0000-0002-4531-9889
Abstract:Immune thrombocytopenia (ITP) is an autoimmune disease mediated by platelet-reactive antibodies, leading to accelerated platelet clearance and an increased risk of bleeding. Despite multiple available therapeutic options, durable treatment-free remissions remain uncommon in patients with refractory disease. Here, we report 3 patients with multidrug refractory ITP treated with a bispecific B-cell maturation antigen (BCMA)–targeting T-cell engager, teclistamab, approved for the treatment of multiple myeloma. Fixed-duration teclistamab therapy–induced platelet response within 4, 9, and 23 days, which was sustained after treatment discontinuation. The entirety of ITP-directed therapies was tapered and discontinued, and the 3 patients remain in treatment-free remission for 8, 6, and 3 months, respectively. Responses were associated with rapid depletion of B cells and plasma cells. Toxicity was manageable and largely limited to low-grade cytokine release syndrome, transient neutropenia, and infections that were readily controlled. These observations highlight BCMA-directed bispecific antibodies as a potential therapeutic strategy in autoimmune hematologic diseases and provide a rationale for prospective clinical trials.
Source:Blood Immunology & Cellular Therapy
ISSN:3050-5976
Publisher:Elsevier
Volume:2
Number:3
Page Range:100062
Number of Pages:1
Date:September 2026
Official Publication:https://doi.org/10.1016/j.bict.2026.100062

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