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For a confirmed deficiency, their guidelines point to a specific type of B12 called hydroxocobalamin, given as an intramuscular injection

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In the phase 3 ELOQUENT-2 clinical trial in patients who had previously received one to three prior lines of therapy, PFS between groups favored elotuzumab with lenalidomide and dexamethasone versus lenalidomide and dexamethasone at 1 year (68% vs 57%) and 2 years (41% vs 27%)