Case Report: Reactive T-cell large granular lymphocytes in the bone marrow of a patient with relapsed/refractory multiple myeloma receiving teclistamab
T-cell engager therapies for the management of relapsed/refractory (R/R) multiple myeloma (MM) may lead to neutropenia with or without associated infections, which can limit treatment and efficacy. We present a case of a patient with penta-class R/R MM who, while receiving teclistamab, developed per...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1630929/full |
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| author | Erin A. Dean Li-Jun Yang Robert P. Seifert John R. Wingard |
| author_facet | Erin A. Dean Li-Jun Yang Robert P. Seifert John R. Wingard |
| author_sort | Erin A. Dean |
| collection | DOAJ |
| description | T-cell engager therapies for the management of relapsed/refractory (R/R) multiple myeloma (MM) may lead to neutropenia with or without associated infections, which can limit treatment and efficacy. We present a case of a patient with penta-class R/R MM who, while receiving teclistamab, developed persistent severe to moderate neutropenia with associated infections. A review of her bone marrow confirmed the eradication of the malignant plasma cells, but flow cytometry identified an increase in T-cell large granular lymphocytes (T-LGLs). Upon further analysis, T-LGLs were found to be reactive and non-clonal, ruling out secondary T-LGL leukemia. This case describes the evolving peripheral blood cell counts, bone marrow composition, and radiologic findings due to the activation of the patient’s immune system before, during, and after treatment with teclistamab. To our knowledge, this is the first reported potential association of T-LGL activation with teclistamab treatment. |
| format | Article |
| id | doaj-art-9474c8f42ada4aa5aa199344ad9bd21d |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-9474c8f42ada4aa5aa199344ad9bd21d2025-08-20T03:44:33ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.16309291630929Case Report: Reactive T-cell large granular lymphocytes in the bone marrow of a patient with relapsed/refractory multiple myeloma receiving teclistamabErin A. Dean0Li-Jun Yang1Robert P. Seifert2John R. Wingard3Department of Medicine, Division of Hematology and Oncology, University of Florida, Gainesville, FL, United StatesDepartment of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, FL, United StatesDepartment of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, FL, United StatesDepartment of Medicine, Division of Hematology and Oncology, University of Florida, Gainesville, FL, United StatesT-cell engager therapies for the management of relapsed/refractory (R/R) multiple myeloma (MM) may lead to neutropenia with or without associated infections, which can limit treatment and efficacy. We present a case of a patient with penta-class R/R MM who, while receiving teclistamab, developed persistent severe to moderate neutropenia with associated infections. A review of her bone marrow confirmed the eradication of the malignant plasma cells, but flow cytometry identified an increase in T-cell large granular lymphocytes (T-LGLs). Upon further analysis, T-LGLs were found to be reactive and non-clonal, ruling out secondary T-LGL leukemia. This case describes the evolving peripheral blood cell counts, bone marrow composition, and radiologic findings due to the activation of the patient’s immune system before, during, and after treatment with teclistamab. To our knowledge, this is the first reported potential association of T-LGL activation with teclistamab treatment.https://www.frontiersin.org/articles/10.3389/fonc.2025.1630929/fullmultiple myelomaT-LGLteclistamabbispecific antibodies (BsAbs)bone marrow microenvironment (BMME) |
| spellingShingle | Erin A. Dean Li-Jun Yang Robert P. Seifert John R. Wingard Case Report: Reactive T-cell large granular lymphocytes in the bone marrow of a patient with relapsed/refractory multiple myeloma receiving teclistamab Frontiers in Oncology multiple myeloma T-LGL teclistamab bispecific antibodies (BsAbs) bone marrow microenvironment (BMME) |
| title | Case Report: Reactive T-cell large granular lymphocytes in the bone marrow of a patient with relapsed/refractory multiple myeloma receiving teclistamab |
| title_full | Case Report: Reactive T-cell large granular lymphocytes in the bone marrow of a patient with relapsed/refractory multiple myeloma receiving teclistamab |
| title_fullStr | Case Report: Reactive T-cell large granular lymphocytes in the bone marrow of a patient with relapsed/refractory multiple myeloma receiving teclistamab |
| title_full_unstemmed | Case Report: Reactive T-cell large granular lymphocytes in the bone marrow of a patient with relapsed/refractory multiple myeloma receiving teclistamab |
| title_short | Case Report: Reactive T-cell large granular lymphocytes in the bone marrow of a patient with relapsed/refractory multiple myeloma receiving teclistamab |
| title_sort | case report reactive t cell large granular lymphocytes in the bone marrow of a patient with relapsed refractory multiple myeloma receiving teclistamab |
| topic | multiple myeloma T-LGL teclistamab bispecific antibodies (BsAbs) bone marrow microenvironment (BMME) |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1630929/full |
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