CORNEAL TOXICITY ASSOCIATED TO BELANTAMAB MAFODOTIN - A CLINICAL CASE
Published 2023
- 27th ESCRS Winter Meeting
Reference: P020
| Type: Free Paper Submission
| DOI:
10.82333/2z9h-m893
Authors:
Joana Santos Oliveira* 1
, João Pinheiro Costa 1
, Pedro Neves Cardoso 1
, Luis Torrão 1
, Raúl Moreira 1
, Fernando Falcão Reis 1
, Ana Maria Cunha 1
1Centro Hospitalar Universitário São João,Porto,Portugal
Purpose
Belantamab mafodotin is an antibody-drug conjugate, which contains Belantamab, a humanized IgG1 monoclonal antibody specific for B-cell maturation antigen. It is an EMA-approved drug for the treatment of relapsed or refractory Multiple Myeloma (MM), given as an intravenous infusion once every 3 weeks. Ophthalmologic evaluation is advised before and during treatment. The aim of this work is to report a case of bilateral keratopathy associated with Belantamab mafodotin therapy.
Setting
Centro Hospitalar Universitário de São João, Porto, Portugal.
Methods
The clinical case is presented along with slit lamp photographs and anterior segment OCT images.
Results
A 50-year-old woman with relapsed multiple myeloma was placed on Belantamab mafodotin. An ophthalmological examination was performed before starting the therapy and no changes were found in the anterior segment. Best corrected visual acuity (BCVA) was 10/10 OU. The patient was advised to start an artificial tear. In the second pre-infusion visit, peripheral microcyst-like epithelial changes were found, more prominent in the right eye (RE), not reaching the visual axis. The patient continued to be seen before each infusion every 3 weeks. However, before the sixth dose, the keratopathy was worse and affected the visual axis. Best corrected visual acuity with manifest refraction decreased to 5/10 in the RE and to 4/10 in the left eye. The treatment was withheld due to the ophthalmic findings. Anterior segment OCT (Heldelberg Spectralis) showed heterogeneous and diffuse corneal epithelium hyper-reflectivity, more pronounced in the RE. Improvement of corneal changes and recovery of vision occurred in another three weeks. So far, the patient underwent one additional treatment.
Conclusion
Belantamab-related corneal changes start at the periphery of the cornea and later progress towards the center. Treatment with Belantamab requires a close collaboration between the Ophthalmologist and Hematologist in order to adjust the treatment according to the keratopathy.