Journal: Blood cancer journal
Study type and population
- Single-center retrospective cohort of 80 patients with relapsed/refractory multiple myeloma treated with teclistamab.
- Median follow-up: 21 months.
Infection burden
- Total infections: 390.
- Severe infections: 48.
- Overall: High infectious burden in this BCMA bispecific–treated population.
Effect of IVIG
- Lower infection rates with IVIG:
- Severe infections: 0.33 vs 0.93 per patient-year with vs without IVIG.
- All-grade infections: 3.15 vs 4.41 per patient-year with vs without IVIG.
- Multivariable analysis: Older age and higher beta-2-microglobulin were linked to increased risk of severe “breakthrough” infections despite IVIG.
Effect of teclistamab dosing interval
- Longer dosing intervals were associated with fewer infections.
- All-grade infections:
- Weekly dosing: 6.08 per patient-year.
- Bimonthly dosing: 2.25 per patient-year.
- Severe infections:
- Weekly dosing: 0.81 per patient-year.
- Bimonthly dosing: 0.10 per patient-year.
Key takeaways for practice
- IVIG appears to meaningfully reduce both severe and all-grade infections in teclistamab-treated RRMM.
- Infection risk remains substantial in older patients and those with higher beta-2-microglobulin, even with IVIG.
- Extending teclistamab dosing intervals may further decrease infection rates.
- Annualized infection rates are a useful metric to capture the true infectious burden in patients receiving BCMA-directed bispecific antibodies.