Al-Ola A Abdallah MD (USMIRC)'s Threads

Jul 3 • 10 tweets • 5 min read

🧵1/🌍🔬
Our new USMIRC analysis evaluated 845 multiple myeloma clinical trials registered on over the past 20 years, examining where trials are conducted, how they have evolved, and who has access to innovation.

#mmsm #myeloma #MedEd #medtwitter #USMIRC @US_HMC @USMIRCNEWS @Larvol @MedwatchKate @oncodaily @CurrentOncologyClinicalTrials.gov

2/ 🌍 The Global Myeloma Trial Boom—But Not Everyone Is Benefiting

MM clinical research has expanded dramatically worldwide, reflecting the rapid evolution of immunotherapy, CAR-T, bispecific antibodies, and targeted therapies. Yet this growth has not been equally distributed.

The United States 🇺🇸🏆 remains the global leader, accounting for nearly 40% of all MM trials, with the highest trial density and the largest concentration of clinical trial sites.

#mmsm #myeloma #MedEd #medtwitter #USMIRC @US_HMC @USMIRCNEWS @Larvol @MedwatchKate @oncodaily

Jun 14 • 9 tweets • 3 min read

🧵 Post-BCMA Failure in RRMM: What should we do next? 🤔

A new multicenter USMIRC/US academic center real-world analysis provides practical insights into sequencing after BCMA-directed therapy failure. Here are the key takeaways for clinicians 👇

1️⃣ BCMA-directed therapy failure is becoming increasingly common, yet the optimal sequencing strategy remains undefined.

📌 This analysis integrates 3 multicenter real-world cohorts evaluating:
🔹 BCMA CAR-T
🔹 BCMA bispecific antibodies
🔹 Talquetamab (GPRC5D)

#mmsm #myeloma #MedEd #Medtwitter #USMIRC @oncodaily @USMIRCNEWS @US_HMC @CurrentOncology @MedwatchKate @Larvol #المايلوما #سرطان_الدم

2️⃣ 🚀 BCMA CAR-T outperformed BCMA bispecifics after prior BCMA exposure.

✅ ORR: 79% vs 51%
✅ Median OS: 30 vs 12 months

👉 When feasible, CAR-T appears to provide the deepest and most durable responses.

#mmsm #myeloma #MedEd #Medtwitter #USMIRC @oncodaily @USMIRCNEWS @US_HMC @CurrentOncology @MedwatchKate @Larvol

Jun 13 • 11 tweets • 3 min read

🚨 MonumenTAL-3 (NEJM 2026): Talquetamab Beats the Old Standard of Care… But the Biggest Question Wasn’t Answered! 🧵

Can Talquetamab Truly Move Earlier—and Where Does It Fit After BCMA-Directed Therapy? Let’s Discuss the Ups, Downs & Future.

1/ Talquetamab continues to reshape the RRMM landscape.

The Phase III #MonumenTAL3 trial compared:
✅ Talquetamab + Daratumumab + Pomalidomide (Tal-DP)
✅ Talquetamab + Daratumumab (Tal-D)
vs
✅ DPd

Patients had ≥1 prior line of therapy.

#mmsm #myeloma #MedEd #Mestwitter #USMIRC @US_HMC @USMIRCNEWS @MedwatchKate @Larvol @oncodaily

2/ 🔥 Primary endpoint met

24-month PFS:
🟢 Tal-DP: 81.3%
🟢 Tal-D: 77.6%
⚪ DPd: 51.2%

HR:
📉 Tal-DP vs DPd = 0.28
📉 Tal-D vs DPd = 0.33

Highly significant improvement.

#mmsm #myeloma #MedEd #Mestwitter #USMIRC @US_HMC @USMIRCNEWS @MedwatchKate @Larvol @oncodaily

Jun 1 • 11 tweets • 4 min read

1/ 🧵 A Dominant Victory for BCMA: Teclistamab Scores Big in MajesTEC-9 from #ASCO26

Teclistamab moves earlier in RRMM!

MajesTEC-9 evaluated teclistamab monotherapy vs PVd/Kd in patients with MM after 1–3 prior lines, all exposed to lenalidomide + anti-CD38 mAb.

This is a very relevant post–Dara/Len era population. 👇

#mmsm #myeloma #USMIRC #MedEd #medtwitter @USMIRCNEWS @US_HMC @MedwatchKate @Larvol @oncodaily

2/ 🚀 Efficacy was impressive:

📌 18-mo PFS: 69.8% vs 26.9%
📌 HR for progression/death: 0.29
📌 CR or better: 65.9% vs 16.8%
📌 ORR: 84.5% vs 54.2%
📌 18-mo OS: 79.2% vs 68.6%
📌 OS HR: 0.60

A strong win for BCMA bispecific therapy earlier in relapse.

#mmsm #myeloma #USMIRC #MedEd #medtwitter @USMIRCNEWS @US_HMC @MedwatchKate @Larvol @oncodaily

Apr 26 • 10 tweets • 3 min read

🧵🚨 Newly Diagnosed High-Risk Myeloma: Does “Double-Hit” Still Predict Worse Outcomes After ASCT?

1/In our multicenter real-world study of 154 transplant-eligible patients with high-risk MM, we compared:

🔹 Single-hit HRMM = 1 high-risk cytogenetic abnormality
🔹 Double-hit HRMM = ≥2 high-risk cytogenetic abnormalities

#MMSM #myeloma #MedEd #medtwitter #USMIRC @US_HMC @MedwatchKate @OncoAlert @Larvol @USMIRCNEWS @CurrentOncology @KUcancercenter

2/📌 Cohort details:

👥 154 patients
🏥 3 U.S. academic centers
📅 Upfront ASCT between 2009–2024
🧬 63 single-hit
🧬 91 double-hit

High-risk lesions included del(17p), t(4;14), t(14;16), t(14;20), 1q gain/amp, and del(1p).

#MMSM #myeloma #MedEd #medtwitter #USMIRC @US_HMC @MedwatchKate @OncoAlert @Larvol @USMIRCNEWS @CurrentOncology @KUcancercenter

Mar 13 • 13 tweets • 4 min read

🧵 High-Risk Myeloma Maintenance

1️⃣🧬 Maintenance Strategies in High-Risk Multiple Myeloma (HRMM)
New multicenter analysis from the USMIRC collaborative compares lenalidomide (R) vs bortezomib + lenalidomide (VR) maintenance after ASCT.

Key question:
👉 Does intensifying maintenance improve outcomes in HRMM?
#mmsm #myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @Larvol @US_HMC @MedwatchKate @OncoAlert

2️⃣ Background
📊 HRMM remains a major challenge despite modern induction + ASCT.

High-risk cytogenetics (per IMWG):
⚠️ del(17p)
⚠️ t(4;14)
⚠️ t(14;16) / t(14;20)
⚠️ +1q gain/amplification
⚠️ Double- or triple-hit disease

Standard maintenance = lenalidomide, but outcomes remain inferior in HRMM.

#mmsm #myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @Larvol @US_HMC @MedwatchKate @OncoAlert

Mar 7 • 10 tweets • 3 min read

Teclistamab in RRMM with Renal Impairment Real-world data from the USMIRC multi-institutional study 🧵

1️⃣🧬 (n=195) shows that teclistamab remains safe and effective even in patients with significant renal dysfunction (CrCl <40 mL/min) — a population excluded from the original MAJESTEC-1 trial.
#mmsm #myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @US_HMC @OncoAlert @MedwatchKate @Larvol

2️⃣ Mechanism Refresher 🔬
Teclistamab = BCMA × CD3 bispecific antibody

➡️ Targets BCMA on myeloma cells
➡️ Engages CD3 on T cells
➡️ Activates cytotoxic response (perforin + granzymes)

Result: T-cell–mediated myeloma cell killing.

#mmsm #myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @US_HMC @OncoAlert @MedwatchKate @Larvol

Feb 25 • 11 tweets • 3 min read

Guess how much it costs to publish a paper in any Heme/Onc Journal? 🧵

Answer in post 3!!

1/ 🌍📚 New study in JCO Oncology Advances explores the global landscape of open-access publishing in hematology/oncology — and the equity gaps are hard to ignore.

#mmsm #Myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @US_HMC @OncoAlert @MedwatchKate @Larvol

2/ 🔎 Study design
• Cross-sectional analysis of 534 journals
• Data from Scopus + Clarivate
• Examined APCs, impact factor (IF), geography, and income level

#mmsm #Myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @US_HMC @OncoAlert @MedwatchKate @Larvol

Jan 30 • 10 tweets • 3 min read

🚨Out now by @AlmaHabibMD published at USMIRC special edition @CurrentOncology

🧵BCMA CAR-T in RRMM pts w/ Renal Impairment (RI)
What happens when CrCl <45 mL/min? Real-world data answer an important gap

1/🧬 Background
• Renal impairment (RI) is common in MM (cast nephropathy, ↑ FLC)
• Pivotal CAR-T trials largely excluded RI pts
• ~10–15% of RRMM pts are trial-ineligible due to kidney dysfunction

➡️ Real-world question: Can BCMA CAR-T still work safely?

#mmsm #myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @US_HMC @OncoAlert @Larvol @MedicalwatchHQ @MedwatchKate

📊 Study Design
• Multicenter retrospective (2021–2024)
• N = 223 RRMM pts
• RI = CrCl <45 mL/min (n=25, 11%)
• Compared to normal renal function (n=198)

#mmsm #myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @US_HMC @OncoAlert @Larvol @MedicalwatchHQ @MedwatchKate

Jan 18 • 7 tweets • 2 min read

🧵 Immune Effector Cell–Associated HLH-like Syndrome (IEC-HS) in CAR-T & TCE-treated myeloma and B-cell malignancies
Insights from a large FAERS pharmacovigilance study 👇

1️⃣ IEC-HS is rare but deadly ⚠️
Among >23,000 AE reports, IEC-HS occurred in 1.6%, yet mortality was >60%.
This is not “just CRS”—it’s a distinct, life-threatening hyperinflammatory syndrome 🔥
#mmsm #myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @US_HMC @Larvol @MedwatchKate @OncoAlert

2️⃣ Who reports it most?
Absolute numbers are highest with axi-cel and tisa-cel—but raw counts mislead.
Utilization ≠ risk. We need signal detection, not anecdotes 📊

3️⃣ Disproportionality analysis (2024 data) reveals:
🔺 tisa-cel → ROR 2.2
🔺 cilta-cel → ROR 2.24
⚖️ axi-cel → no disproportionate signal (ROR ~1)
🔽 teclistamab → lower reporting (ROR 0.43)

#mmsm #myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @US_HMC @Larvol @MedwatchKate @OncoAlert

Jan 5 • 11 tweets • 3 min read

🧵Outcomes of pPCL Diagnosed Using the IMWG 2021 Consensus Definition: Retrospective Multicenter #USMIRC Analysis

1️⃣ pPCL in 2025: still ultra–high risk 🧬🔥
New multicenter data using IMWG 2021 criteria (≥5% circulating plasma cells) confirms: prognosis remains poor—but modern transplant strategies matter.
#mmsm #Myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @US_HMC @MedwatchKate @OncoAlert @Larvol

2️⃣ Study snapshot 🧪
📊 67 pts | 2010–2023 | 3 academic centers
• Median age: 64
• High-risk cytogenetics: 60%
• EMD: 24%
• 25% met new pPCL criteria only (5–20% CPC)

#mmsm #Myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @US_HMC @MedwatchKate @OncoAlert @Larvol

Dec 2, 2025 • 12 tweets • 3 min read

🧵Utility of Neurotoxicity Investigations in CD19 and BCMA CART Recipients with ICANS

1/ Optimizing Neurotoxicity Testing in CAR T-Cell Therapy Recipients

A major retrospective study (n=347) clarifies which neurodiagnostic tests actually help in evaluating ICANS. Spoiler: not all tests are created equal. 👇🧠
#mmsm #MedEd #medtwitter #USMIRC @USMIRCNEWS @OncoAlert @MedwatchKate @US_HMC @Larvol #myeloma #سرطان_الدم #المايلوما

2/ Background 🧬
CAR T-cell therapy is transformative for B-ALL, NHL, and MM—but ICANS remains a serious toxicity.
Guidelines conflict on when to use MRI, CSF studies, or EEG, leaving clinicians uncertain. This study bridges that gap. ⚖️

#mmsm #MedEd #medtwitter #USMIRC @USMIRCNEWS @MedwatchKate @US_HMC @Larvol #myeloma #سرطان_الدم #المايلوما

Nov 26, 2025 • 11 tweets • 3 min read

🧵 All #ASH25 abstracts for #mmsm in a tweet 10+ Bonus:

1/10: Presentation ID 2387
OL-101, a BCMA/GPRC5D dual-targeting autologous CAR-T for relapsed/ refractory multiple myeloma (R/R MM): Results from a Phase I study

#mmsm #Myeloma #USMIRC #MedEd #MedTwitter @USMIRCNEWS @MedwatchKate @Larvol @US_HMC #سرطان_الدم #المايلوما 2/10: Presentation ID 253
Combined biparatopic nanobody-based B cell maturation antigen chimeric antigen receptor T cell therapy and pomalidomide for relapsed or refractory multiple myeloma: In-vitro characterisation and phase 1 dose-escalation study

#mmsm #Myeloma #USMIRC #MedEd #MedTwitter @USMIRCNEWS @MedwatchKate @Larvol @US_HMC #سرطان_الدم #المايلوما

Nov 21, 2025 • 10 tweets • 2 min read

7/10 Abstract from #ASH25:

1/🚀 Phase 2 IMMUNOPLANT Study Update!
Exploring abbreviated, fixed-duration (4 cycles) linvoseltamab (Linvo) immuno-consolidation to deepen responses in newly diagnosed multiple myeloma patients who remain MRD-positive after triplet/quad therapy.
A study from USA 🇺🇸
#Myeloma #Oncology

#mmsm #myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert @MedwatchKate @Larvol @US_HMC #المايلوما #سرطان_الدم 2/🧬 Why this matters:
Even with modern quadruplet regimens (PI + IMiD + anti-CD38), about 50% of NDMM patients stay MRD-positive.
Linvoseltamab (a CD3xBCMA bispecific) may push responses deeper — without HDM-ASCT for those who defer it.
#mmsm #myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert @MedwatchKate @Larvol @US_HMC #المايلوما #سرطان_الدم

Nov 16, 2025 • 10 tweets • 2 min read

5/10 ASH abstracts in #myeloma #ASH25
This one must make the list!!

🧵1/🚀 Promising new real-world data from China 🇨🇳!

Equecabtagene autoleucel (eque-cel) after ASCT shows strong safety & efficacy in ultra–high-risk multiple myeloma (UHR-MM) patients.
#MedEd #MedTwitter #mmsm #myeloma #USMIRC @USMIRCNEWS @MedwatchKate @Larvol @US_HMC @OncoAlert @oncodaily #سرطان_الدم #المايلوما 2/🧬 Why it matters:
UHR-MM patients still face poor outcomes despite advances in MM therapy. New strategies are urgently needed. Eque-cel, a BCMA-CAR-T therapy, is being explored earlier in treatment.

#MedEd #MedTwitter #mmsm #myeloma #USMIRC @USMIRCNEWS @MedwatchKate @Larvol @US_HMC @OncoAlert @oncodaily #سرطان_الدم #المايلوما

Nov 14, 2025 • 7 tweets • 2 min read

from #ASH25 Day 3:
3/10;
🧵 Thread: Phase 2 Study of Aponermin + KT-DECP in RRMM with EMD a study from China 🇨🇳 Kudus for the group to design a study focusing on EMD 👍🏻👏🏻👏🏻

1️⃣ 🔬 RRMM with extramedullary disease (EMD) remains a high-risk population (3-yr OS ≈ 58%).
Aponermin (Apo), a DR4/DR5 agonist, activates the extrinsic apoptosis pathway via caspase signaling.
This trial evaluated Apo + KT-DECP in RRMM + EMD.

#USMIRC @USMIRCNEWS @OncoAlert @US_HMC @MedwatchKate @Larvol #MedTwitter #MedEd #mmsm @ASH_hematology #المايلوما #سرطان_الدم 2️⃣ 🧪 Study Design
•Multicenter, single-arm phase 2 (NCT05013190)
•Planned N=31; current N=23
•EMD confirmed per IMWG
•Apo-KT-DECP for 4–6 cycles; RT added if •Primary endpoint: ORR after 2 cycles
•Secondary: CR, ≥VGPR, time to response (TOR), safety

#USMIRC @USMIRCNEWS @OncoAlert @US_HMC @MedwatchKate @Larvol #MedTwitter #MedEd #mmsm @ASH_hematology #المايلوما #سرطان_الدم

Nov 5, 2025 • 9 tweets • 3 min read

🚨The Future of BiTEs, especially in combination therapy trials, should be focused on fixed duration 👍 👍👍

🧵 Teclistamab Dosing Strategies in #MultipleMyeloma: Continuous vs. Fixed-Duration Therapy :

1/Study Snapshot
📊 Multicenter, real-world retrospective analysis (n=88)
💊 Compared continuous (n=72) vs. fixed-duration (n=16) teclistamab in relapsed/refractory #MM
🎯 Goal: Evaluate if stopping after deep response compromises outcomes

#ICE_T #mmsm #MedEd #myeloma #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما @oncodaily @MedwatchKate @MDPIOpenAccess @CancerNetwrk @KUcancercenter @SaudiMyeloma #السعودية

2/Core Finding
✅ Fixed-duration strategy appears feasible for select patients
📈 12-mo PFS ~same: 65% (continuous) vs. 66% (fixed)
⚠️ BUT: Severe infection risk 🚨 much higher in fixed-duration group (69% vs. 22%)

#ICE_T #mmsm #MedEd #myeloma #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

Oct 15, 2025 • 11 tweets • 3 min read

An Interesting Paper ⬇️⬇️⬇️
🧵 Prognostic Value of Splenomegaly in BCMA CAR-T Therapy for Myeloma

📍Study from Univ. Hospital Leipzig explores whether spleen size can predict outcomes in RRMM patients receiving BCMA-CAR-T (ide-cel or cilta-cel).
#Myeloma #CARTcell #HemOnc #Immunotherapy

#ICE_T #mmsm #MedEd #myeloma #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

1️⃣ Why spleen size?
🩸 CAR-T success varies widely. Existing scores (EASIX, CAR-HEMATOTOX, sBCMA) predict toxicity & survival—but none account for immune sequestration or EMH.
👉 Hypothesis: an enlarged spleen = immune “sink” that impairs CAR-T expansion.

#ICE_T #mmsm #MedEd #myeloma #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

Oct 4, 2025 • 7 tweets • 3 min read

🧵 Real-World Efficacy & Safety of Ciltacabtagene Autoleucel (Cilta-cel) in Multiple Myeloma

1️⃣ Study Snapshot
Real-world (RW) data compared cilta-cel outcomes in relapsed/refractory MM vs the pivotal CARTITUDE-1 trial 💥
Despite higher-risk features, survival outcomes were strikingly similar! ⚖️

#ICE_T #mmsm #MedEd #myeloma #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

2️⃣ Baseline Differences
RW pts had:
🧬 More extramedullary disease (29% vs 13%)
⚡ Worse performance status (ECOG 0: 16% vs 40%)
🧠 45% would’ve been ineligible for CARTITUDE-1 — yet still benefitted!

#ICE_T #mmsm #MedEd #myeloma #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

May 27, 2025 • 8 tweets • 3 min read

🧵The Impact of Sponsors on Development of Clinical Research in Multiple Myeloma and AL Amyloidosis

1/Importance of Sponsoring Sources: Academic (AS), industrial (IS), & government sectors play crucial roles in funding and advancing medical research

#mmsm #myeloma #MedEd #MedTwitter #USMIRC @OncoAlert @USMIRCNEWS #سرطان_الدم #المايلوما

2/Multiple Myeloma trials: Industrial trials constitute the largest proportion of MM trials (40%), followed closely by AS trials (37%).
Phase 2 trials are also the most common (61%), with AS leading in this phase (44%). However, industry significantly dominates both Phase 1 (54%) and Phase 3 (62%) MM trials. This suggests a greater industry focus on early-stage exploration and late-stage validation.

#mmsm #myeloma #MedEd #MedTwitter #USMIRC @OncoAlert @USMIRCNEWS #سرطان_الدم #المايلوما

May 10, 2025 • 8 tweets • 3 min read

🧵Intrathecal chemotherapy for ciltacabtagene autoleucel-associated movement and
neurocognitive toxicity

1/ Cilta-cel-associated parkinsonism is a rare but serious delayed toxicity

*🚨Incidence reported in this study was 8% (5 cases out of the first 60 consecutive patients).
♾️ Previous studies cited show varying incidence rates: 6% in CARTITUDE-1, 1% in CARTITUDE-4, and 2% in commercial cilta-cel treatment.
#mmsm #myeloma #MedEd #medtwitter #USMIRC @USMIRCNEWS @OncoAlert #المايلوما #سرطان_الدم

2/🌡️ Characteristics of Cilta-cel-associated Parkinsonism: The onset is typically subacute, emerging approximately 1-2 months after CAR T-cell infusion.

**The median time to onset in this study was 26 days (range 9-36).
⚛️ Common symptoms observed in all 5 pts included personality changes (flat affect, anhedonia, avolition), difficulty with word finding, masked facies, anosmia, resting tremor, rigidity, impaired swallowing, micrographia, bradykinesia, & shuffling gait.

#mmsm #myeloma #MedEd #medtwitter #USMIRC @USMIRCNEWS @OncoAlert #المايلوما #سرطان_الدم

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