What question did this study set out to answer?

This study aims to evaluate the association between Belantamab mafodotin treatment and the occurrence of Macro-LDH in patients with relapsed/refractory multiple myeloma.

April 18, 2026

Can Belantamab mafodotin cause macro LDH?

Key Points

This study aims to evaluate the association between Belantamab mafodotin treatment and the occurrence of Macro-LDH in patients with relapsed/refractory multiple myeloma.
Retrospective analysis of 40 RRMM patients receiving Belamaf from July 2019 to December 2024.
Assessment of LDH levels following treatment initiation.
Comprehensive clinical evaluation of six patients diagnosed with Macro-LDH.
Multivariate analysis to determine the association between Belamaf cycles and elevated LDH.
67.5% of patients experienced elevated LDH levels after receiving Belamaf.
Macro-LDH was diagnosed in six patients following detailed evaluations.
LDH levels returned to normal after discontinuation of Belamaf in affected individuals.
Higher cumulative cycles of Belamaf were significantly associated with increased LDH levels.

Abstract

Belantamab mafodotin (Belamaf), an anti-BCMA antibody-drug conjugate (ADC), is indicated for relapsed/refractory multiple myeloma (RRMM). This retrospective, single-center study evaluated 40 RRMM patients who received ≥2 Belamaf cycles between July 2019 and December 2024. Following treatment initiation, 27 patients (67.5%) exhibited elevated lactate dehydrogenase (LDH) levels. Six patients underwent comprehensive clinical evaluation and were diagnosed with Macro-LDH. LDH levels declined following Belamaf cessation in all affected individuals. Multivariate analysis revealed that a higher cumulative number of Belamaf cycles was significantly associated with elevated LDH (OR 1.11, 95% CI 1.0-1.2, p = 0.045). This study provides the first report of potentially Belamaf-associated Macro-LDH formation. Awareness of this benign phenomenon is essential to prevent unnecessary diagnostic investigations, thereby reducing patient burden and healthcare costs.

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