HIGH INFECTION BURDEN IN MULTIPLE MYELOMA TREATED WITH CONVENTIONAL THERAPIES AND BISPECIFIC ANTIBODIES: REAL-WORLD DATA
- 1A.C. Camargo Cancer Center, São Paulo, SP, Brazil
Abstract
Background: Infections are clinically relevant complications of multiple myeloma treatment, particularly following therapies associated with prolonged immunosuppression. Real-world data on infections among patients receiving bispecific antibodies remain limited. Objectives: To describe the incidence, classification, and severity of infections among patients treated with conventional therapies or bispecific antibodies (talquetamab, teclistamab, or elranatamab), as well as all-cause mortality within 30 days after infection. Materials and Methods: This retrospective cohort included 121 patients with multiple myeloma: 96 received conventional therapies and 25 received bispecific antibodies. Infections were classified as clinically documented, microbiologically documented, or febrile neutropenia and graded from 1 to 5. Thirty-day mortality was calculated from the most recent infection and included patients with a documented death or at least 30 days of follow-up. Descriptive analyses were performed. Results: During follow-up, 97/121 (80.2%) patients experienced at least one infection. A total of 323 dated episodes were recorded, of which 312 were classified: 215 (68.9%) were clinically documented, 89 (28.5%) were microbiologically documented, and eight (2.6%) were episodes of febrile neutropenia. The observed incidence was 76/96 (79.2%) with conventional therapies and 21/25 (84.0%) with bispecific antibodies. Among conventional therapies, 262 episodes were classified: 187 (71.4%) were clinically documented, 68 (26.0%) were microbiologically documented, and seven (2.7%) were febrile neutropenia. Among bispecific antibodies, the corresponding distributions were 28/50 (56.0%), 21/50 (42.0%), and 1/50 (2.0%). With conventional therapies, the numbers of grade 1/2/3/4/5 infections were 12/149/95/11/0; with bispecific antibodies, they were 1/21/18/8/2. Among evaluable patients, 30-day mortality after infection was 0/72 with conventional therapies and 5/17 (29.4%) with bispecific antibodies. Discussion: The occurrence of infections was high with both therapeutic modalities, demonstrating a substantial clinical burden throughout multiple myeloma treatment. No deaths within 30 days after infection were observed among evaluable patients receiving conventional therapies, whereas deaths occurred in the bispecific antibody group. This finding should be interpreted cautiously because of the small sample size, treatment heterogeneity, differences in exposure duration, and incomplete follow-up. Given the descriptive design, no relative risks or causal associations can be established. These findings reinforce the importance of infection prevention, early recognition, and timely treatment. Conclusion: Infections were frequent among patients receiving conventional therapies and bispecific antibodies. The early mortality observed among patients receiving bispecific antibodies should be interpreted in light of the cohort’s limitations but underscores the need for infection surveillance, individualized prophylaxis, and systematic follow-up. Prospective studies are required to estimate treatment-specific risks.
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BibTeX
@article{peruzini2026high,
title = {{HIGH INFECTION BURDEN IN MULTIPLE MYELOMA TREATED WITH CONVENTIONAL THERAPIES AND BISPECIFIC ANTIBODIES: REAL-WORLD DATA}},
author = {Giovanna Alves PERUZINI and Julia Aith BALTAZAR and Matheus Lima GARCIA and Julia Curi AMARANTE and Humberto VILLEFORT and Jayr SCHMIDT- FILHO and Marjorie Vieira BATISTA},
journal = {Hematology, Transfusion and Cell Therapy},
year = {2026},
month = oct,
doi = {10.1016/j.htct.2026.106785},
url = {https://doi.org/10.1016/j.htct.2026.106785},
note = {CC BY},
}
RIS
TY - JOUR
TI - HIGH INFECTION BURDEN IN MULTIPLE MYELOMA TREATED WITH CONVENTIONAL THERAPIES AND BISPECIFIC ANTIBODIES: REAL-WORLD DATA
AU - Giovanna Alves PERUZINI
AU - Julia Aith BALTAZAR
AU - Matheus Lima GARCIA
AU - Julia Curi AMARANTE
AU - Humberto VILLEFORT
AU - Jayr SCHMIDT- FILHO
AU - Marjorie Vieira BATISTA
PY - 2026
DA - 2026/10/23
JO - Hematology, Transfusion and Cell Therapy
DO - 10.1016/j.htct.2026.106785
UR - https://doi.org/10.1016/j.htct.2026.106785
AB - Background: Infections are clinically relevant complications of multiple myeloma treatment, particularly following therapies associated with prolonged immunosuppression. Real-world data on infections among patients receiving bispecific antibodies remain limited. Objectives: To describe the incidence, classification, and severity of infections among patients treated with conventional therapies or bispecific antibodies (talquetamab, teclistamab, or elranatamab), as well as all-cause mortality within 30 days after infection. Materials and Methods: This retrospective cohort included 121 patients with multiple myeloma: 96 received conventional therapies and 25 received bispecific antibodies. Infections were classified as clinically documented, microbiologically documented, or febrile neutropenia and graded from 1 to 5. Thirty-day mortality was calculated from the most recent infection and included patients with a documented death or at least 30 days of follow-up. Descriptive analyses were performed. Results: During follow-up, 97/121 (80.2%) patients experienced at least one infection. A total of 323 dated episodes were recorded, of which 312 were classified: 215 (68.9%) were clinically documented, 89 (28.5%) were microbiologically documented, and eight (2.6%) were episodes of febrile neutropenia. The observed incidence was 76/96 (79.2%) with conventional therapies and 21/25 (84.0%) with bispecific antibodies. Among conventional therapies, 262 episodes were classified: 187 (71.4%) were clinically documented, 68 (26.0%) were microbiologically documented, and seven (2.7%) were febrile neutropenia. Among bispecific antibodies, the corresponding distributions were 28/50 (56.0%), 21/50 (42.0%), and 1/50 (2.0%). With conventional therapies, the numbers of grade 1/2/3/4/5 infections were 12/149/95/11/0; with bispecific antibodies, they were 1/21/18/8/2. Among evaluable patients, 30-day mortality after infection was 0/72 with conventional therapies and 5/17 (29.4%) with bispecific antibodies. Discussion: The occurrence of infections was high with both therapeutic modalities, demonstrating a substantial clinical burden throughout multiple myeloma treatment. No deaths within 30 days after infection were observed among evaluable patients receiving conventional therapies, whereas deaths occurred in the bispecific antibody group. This finding should be interpreted cautiously because of the small sample size, treatment heterogeneity, differences in exposure duration, and incomplete follow-up. Given the descriptive design, no relative risks or causal associations can be established. These findings reinforce the importance of infection prevention, early recognition, and timely treatment. Conclusion: Infections were frequent among patients receiving conventional therapies and bispecific antibodies. The early mortality observed among patients receiving bispecific antibodies should be interpreted in light of the cohort’s limitations but underscores the need for infection surveillance, individualized prophylaxis, and systematic follow-up. Prospective studies are required to estimate treatment-specific risks.
SN - 2531-1379
SN - 2531-1387
ER -