IVIG Reduces Infection Risk During Anti-BCMA Treatment for MM

Data suggests the bispecific BCMA-targeted antibody teclistamab may lead to grade 3 to 5 infections in as many as 44.8 percent of multiple myeloma (MM) patients, and hypogammaglobulinemia was noted in nearly 75 percent of patients. Fortunately, a recent study shows the use of intravenous immune globulin (IVIG) appears to reduce infection risk by as much as 90 percent in these patients who respond to treatment with anti-BCMA bispecific antibodies.

In the study, researchers sought to characterize hypogammaglobulinemia and infection risk among patients with MM receiving BCMA-targeting bispecific antibodies, and further to determine whether IVIG may alleviate infection risk. Of the 37 patients enrolled, the average patient age was 66 years, 62 percent were female, 65 percent had high-risk cytogenetics and the median number of prior therapy lines was seven.

Analysis showed that grade 3 to 5 infection occurred in 41 percent of patients. There were two deaths due to infection that occurred during deep MM remission; 84 percent of infections overall occurred during remission. The probability of infection increased over time, with no peak level of risk noted. Among the 26 patients who responded to anti-BCMA treatment, 100 percent had profound hypogammaglobulinemia. While patients were receiving IVIG, grade 3 to 5 infections occurred 90 percent less frequently (incidence risk ratio, 0.1; P =.0307).

“With a deeper understanding of effective preventive measures for infections, we can maximize the potential of these highly efficacious immunotherapies in multiple myeloma,” said the study authors.