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Cited by 140Multiple Myeloma Research and TreatmentsMonoclonal and Polyclonal Antibodies ResearchNeutropenia and Cancer Infections

The DOI matches its Crossref record; 43 of the 43 references it cites were found in a registry or an index.

IVIg Use Associated with Ten-Fold Reduction of Serious Infections in Multiple Myeloma Patients Treated with Anti-BCMA Bispecific Antibodies

Open access
Lancman, Guido, Parsa, Kian, Kotlarz, Krzysztof, Avery, Lisa, Lurie, Alaina, Lieberman-Cribbin, Alex, Cho, Hearn Jay, Parekh, Samir S., Richard, Shambavi, Richter, Joshua, Rodriguez, Cesar, Rossi, Adriana, Sanchez, Larysa J., Thibaud, Santiago, Jagannath, Sundar, Chari, Ajai·2023·Blood Cancer Discovery
DOI 10.1158/2643-3230.bcd-23-0049PMC PMC10618720

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Abstract

BCMA-targeted bispecific antibodies (BiAb) are efficacious in relapsed/refractory multiple myeloma; however, serious infections have emerged as important toxicities. In this retrospective study, we characterized all infections and their risk factors, and evaluated the impact of infection prophylaxis in patients treated with BCMA-targeted BiAbs. Among 37 patients, 15 (41%) experienced a grade 3–5 infection, with two infection-related deaths during deep remissions. Most (84%) infections occurred during disease remissions. The cumulative probability of grade 3–5 infection increased over time with no plateau. Among responders (n = 26), profound hypogammaglobulinemia occurred in 100% and continued throughout the entire duration of treatment. During periods when patients were receiving intravenous immunoglobulin (IVIg), the rate of grade 3–5 infections was 90% lower than during observation (incidence rate ratio, 0.10; 95% confidence interval, 0.01–0.80; P = 0.0307). No other risk factors for infection were identified. This study demonstrates that profound hypogammaglobulinemia is universal with BCMA-targeted BiAbs, with intravenous immunoglobulin potentially abrogating most of the infection risk. Significance: To the best of our knowledge, this is the first study to comprehensively analyze risk factors and mitigation strategies to prevent infections in myeloma patients receiving anti-BCMA bispecific antibodies. Profound and prolonged hypogammaglobulinemia was universal among responders, while immunoglobulin replacement was associated with 90% lower rates of grade 3–5 infections. See related commentary by Garfall and Stadtmauer, p. 427 . This article is featured in Selected Articles from This Issue, p. 419

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Crossref · 10.1158/2643-3230.bcd-23-0049

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Metadata

Authors
Lancman, G., Parsa, K., Kotlarz, K., Avery, L., Lurie, A., Lieberman-Cribbin, A., Cho, H. J., Parekh, S. S., Richard, S., Richter, J., Rodriguez, C., Rossi, A., Sanchez, L. J., Thibaud, S., Jagannath, S., & Chari, A.
Affiliations
  • Princess Margaret Cancer Centre (CA)
  • Icahn School of Medicine at Mount Sinai (US)
  • Wrocław University of Environmental and Life Sciences (PL)
  • University Health Network (CA)
  • Tisch Cancer Institute (US)
  • University of California, San Francisco (US)
Corresponding author
Lancman, Guido
ORCID
Venue
Blood Cancer Discovery
Publisher
American Association for Cancer Research (AACR)
Published
2023-09-28
Volume
4
Issue
6
Pages
440-451
ISSN
  • 2643-3230 (ISSN-L)
  • 2643-3249
DOI
10.1158/2643-3230.bcd-23-0049
PMC
PMC10618720
OpenAlex
W4387128075
Cited by
140
References
43
Citations by year
2026: 50 · 2025: 49 · 2024: 35 · 2023: 6
FWCI
28.92
Type
journal article
Language
en
Open access
Locations
  • Blood Cancer Discovery (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
Polish National Agency for Academic Exchange (Preludium BIS 1 (2019/35/O/NZ9/00237))
Topics
  • Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
  • Life Sciences › Immunology and Microbiology › Immunology › Monoclonal and Polyclonal Antibodies Research
  • Health Sciences › Medicine › Oncology › Neutropenia and Cancer Infections
Keywords
intravenous immunoglobulin, multiple myeloma, serious infections, hypogammaglobulinemia, infection control, infection risk factors, relapsed/refractory multiple myeloma, immunoglobulin replacement therapy
MeSH terms
Agammaglobulinemia, Humans, Multiple Myeloma, Retrospective Studies, Immunoglobulins, Intravenous, Antibodies, Bispecific, B-Cell Maturation Antigen

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