First case report of talquetamab use in AL amyloidosis

AL amyloidosis (AL) is a rare plasma cell disorder with limited treatment options in the relapsed/refractory (R/R) setting. Talquetamab, a bispecific T-cell engager targeting GPRC5D, has demonstrated efficacy in multiple myeloma, but its use in AL has not been reported. We describe the first case of talquetamab treatment in a heavily pretreated patient with AL amyloidosis and cardiac involvement. The patient tolerated treatment well, with no cardiac toxicity, and achieved a stringent complete response with cardiac and hematologic improvement. Adverse events included dysgeusia, weight loss, and mild cytopenias, which were manageable. This case highlights the potential role of talquetamab in R/R AL, demonstrating both efficacy and safety. Further studies are needed to evaluate its broader applicability in this fragile patient population.