{
  "abstract": "T-cell redirection therapies, including bispecific antibodies (BsAbs) and chimeric antigen receptor (CAR) T therapy, have transformed the treatment of relapsed or refractory hematologic malignancies. However, comparative data on infectious complications between these treatments remain limited. We performed a propensity score-matched analysis of adults with hematologic malignancies treated with BsAbs or CAR T using the TriNetX global research network. To mitigate confounding, we utilized 1:1 propensity score matching (caliper 0.1) to balance cohorts on demographics, malignancy type, comorbidities, and prior treatments. The primary outcome was 1-year infection hazard in BsAbs vs. CAR T. We included 2 192 matched patients (1 096/group; mean age 65.8 (11.4) years for BsAbs, 65.4 (10.2) years for CAR T). Multiple myeloma was the most common malignancy (~62%). At 1 year, infection hazard was not statistically different between cohorts (BsAbs: 57% vs. CAR T: 55.9%; HR: 1.07; 95% CI: [0.96–1.20]). Early phase infection hazard (days 1–30) was lower with BsAbs but not statistically significant (HR: 0.87; 95% CI: [0.74–1.02]). However, BsAbs therapy was associated with higher infection hazard during intermediate (days 31–180; HR: 1.27; 95% CI: [1.10–1.46]) and late phases (days 181–365; HR: 1.20; 95% CI: [1.01–1.41]). In the late phase, BsAbs carried higher hazard for fungal (HR: 2.14; 95% CI: [1.26–3.64]) and viral pathogens (HR: 1.32; 95% CI: [1.02–1.73]). Respiratory tract infections were the most frequent complication and were higher with BsAbs across all time windows (1-year: 35.4% vs. 30.4%; HR: 1.32; 95% CI: [1.14–1.53]). In conclusion, among patients captured within TriNetX, the overall observed 1-year infection rate did not differ significantly between BsAbs and CAR T therapy. However, BsAbs therapy was associated with higher coded rates of late-onset infections after extensive adjustment, although residual confounding from disease severity and treatment duration remains possible. Further studies must better define this infection burden and optimize prevention strategies.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medicine, Houston Methodist Research Institute, Houston, TX USA",
    "Faculty of Medicine, Cairo University, Cairo, Egypt",
    "School of Rural, Surveying and Geoinformatics Engineering, National Technical University of Athens, Athens, Greece",
    "School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece",
    "Department of Medicine, Weill Cornell Medical College, New York, USA"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Mark Michael"
    },
    {
      "affs": [
        1
      ],
      "name": "Fady Mishriky",
      "orcid": "0000-0002-1947-1721"
    },
    {
      "affs": [
        0
      ],
      "name": "Konstantinos Ouranos"
    },
    {
      "affs": [
        1
      ],
      "name": "Nadine Hassan"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Evangelia K. Mylona"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Fadi Shehadeh"
    },
    {
      "affs": [
        0
      ],
      "name": "Tilemachos Koutouratsas",
      "orcid": "0000-0001-5161-7383"
    },
    {
      "affs": [
        0
      ],
      "name": "Diana Avila"
    },
    {
      "affs": [
        0
      ],
      "name": "Siddharth Das"
    },
    {
      "affs": [
        0
      ],
      "name": "Jenny Petkova"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Eleftherios Mylonakis",
      "orcid": "0000-0002-4624-0777"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e9b9djaz6447d.bib",
  "cited_by": 0,
  "doi": "10.1038/s41408-026-01599-4",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13748598/",
  "id": "e9b9djaz6447d",
  "issns": [
    "2044-5385"
  ],
  "landing_url": "https://doi.org/10.1038/s41408-026-01599-4",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Article"
    ],
    [
      "openalex",
      "2730|CAR-T cell therapy research"
    ]
  ],
  "openalex": "W7202258570",
  "pdf_url": "https://www.nature.com/articles/s41408-026-01599-4_reference.pdf",
  "pmcid": "PMC13748598",
  "pmid": "43003799",
  "published": "2026-08-13",
  "publisher": "Nature Publishing Group",
  "ris": "https://research.draconitic.com/paper/e9b9djaz6447d.ris",
  "sources": [
    {
      "first_seen": "2026-11-13T12:26:34Z",
      "native_id": "PMC13748598",
      "source": "pmc",
      "url": "https://doi.org/10.1038/s41408-026-01599-4"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|CAR-T cell therapy research",
      "subfield": "oncology"
    }
  ],
  "title": "Infectious complications following bispecific antibody or CAR T therapy in adult patients with hematologic malignancies: a retrospective database analysis",
  "title_text": "Infectious complications following bispecific antibody or CAR T therapy in adult patients with hematologic malignancies: a retrospective database analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-13T12:26:34Z",
  "url": "https://research.draconitic.com/paper/e9b9djaz6447d",
  "venue": "Blood Cancer Journal",
  "versions": []
}