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Frequent occurrence of hypophosphatemia among multiple myeloma patients treated with elotuzumab: a single clinic retrospective study

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Abstract

The purpose of this single-center retrospective study was to determine the incidence of decreased blood phosphorus levels and hypophosphatemia among multiple myeloma (MM) patients treated with elotuzumab. Hypophosphatemia, which is defined as a serum phosphorus concentration < 2.5 mg/dL, leads to complications ranging from muscle weakness and disorientation to seizures and heart failure. A total of 23 MM patients receiving care in a clinic specializing in treatment of MM from July 2018 to March 2020 and treated with an elotuzumab-containing therapy were evaluated, and 9 were investigated for this study. Elotuzumab was given at 10 mg/kg weekly for the first two treatment cycles (28 days/cycle), followed by 10 mg/kg every other week for all subsequent cycles. Four different elotuzumab combination therapies were administered: 1) elotuzumab and dexamethasone 2) elotuzumab, lenalidomide and dexamethasone 3) elotuzumab, pomalidomide and dexamethasone and 4) elotuzumab, carfilzomib, pomalidomide, and dexamethasone. Phosphorous levels were determined at a median of every 13 days at intervals ranging from once weekly to once monthly until a phosphate supplement was prescribed to the patient or when elotuzumab treatment was discontinued. We found that regardless of elotuzumab combination therapy, all patients treated showed decreased phosphorus levels after initiating elotuzumab treatment with reductions ranging from 12.5% to 44.1% below baseline. Six participants (67%) demonstrated an average serum phosphorus at or below 2.5 mg/dL after starting elotuzumab therapy. This retrospective study suggests that hypophosphatemia commonly occurs among MM patients receiving elotuzumab-containing therapies.

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Author information

Authors and Affiliations

  1. James R. Berenson, MD, Inc., West Hollywood, CA, 90069, USA

    Bernard Regidor, Regina Swift, Benjamin Eades, Marsiye Emamy-Sadr, Fadi Tarhini & James R. Berenson

  2. Oncotherapeutics, , West Hollywood, CA, 90069, USA

    Tanya M. Spektor & James R. Berenson

  3. Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA

    James R. Berenson

Authors
  1. Bernard Regidor
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  2. Regina Swift
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Contributions

JRB designs the study. RS, BE, BR, MES collected data. BR and TMS analyzed the data. BR, JRB and TMS wrote manuscript. FT provided critical review and edits to manuscript.

Corresponding author

Correspondence to James R. Berenson.

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Ethics approval

This study was approved by the institutional review board and all procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. All patients provided written informed consent. The study was conducted in accordance with the principles of the Declaration of Helsinki 1964 and its later amendments, and International Conference on Harmonization Good Clinical Practice guidelines.

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All patients provided written informed consent.

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Regidor, B., Swift, R., Eades, B. et al. Frequent occurrence of hypophosphatemia among multiple myeloma patients treated with elotuzumab: a single clinic retrospective study. Ann Hematol 100, 1079–1085 (2021). https://doi.org/10.1007/s00277-020-04351-5

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  • DOI: https://doi.org/10.1007/s00277-020-04351-5

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