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Case Reports
. 2023 Dec;203(5):736-746.
doi: 10.1111/bjh.18909. Epub 2023 Jun 7.

Recommendations on prevention of infections during chimeric antigen receptor T-cell and bispecific antibody therapy in multiple myeloma

Meera Mohan  1 , Rajshekhar Chakraborty  2 , Susan Bal  3 , Anoma Nellore  4 , Muhamed Baljevic  5 , Anita D'Souza  1 , Peter G Pappas  4 , Jesus G Berdeja  6 , Natalie Callander  7 , Luciano J Costa  3
Affiliations
Case Reports

Recommendations on prevention of infections during chimeric antigen receptor T-cell and bispecific antibody therapy in multiple myeloma

Meera Mohan et al. Br J Haematol. 2023 Dec.

Abstract

Chimeric antigen receptor T (CAR T) cell and bispecific antibody therapies have shown unprecedented efficacy in heavily pretreated patients with multiple myeloma (MM). However, their use is associated with a significant risk of severe infections, which can be attributed to various factors such as hypogammaglobulinemia, neutropenia, lymphopenia, T-cell exhaustion, cytokine-release syndrome and immune-effector cell-associated neurotoxicity syndrome. As these therapies have been recently approved by regulatory agencies, it is crucial to establish practical guidelines for infection monitoring and prevention until robust data from prospective clinical trials become available. To address this issue, a panel of experienced investigators from the Academic Consortium to Overcome Multiple Myeloma through Innovative Trials (COMMIT) developed consensus recommendations for mitigating infections associated with CAR T-cell and bispecific antibody therapies in MM patients.

Keywords: bispecific T-cell; chimeric antigen receptor T-cell; immunotherapy; infection; multiple myeloma.

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Conflict of interest statement

Conflict of interest disclosure: M.M received Institutional Research funding from GlaxoSmithKline plc, Takeda Pharmaceutical Company, Ionis Pharmaceuticals, Bristol-Myers Squibb Company, Celgene Corporation and Amgen Inc.; Advisory board : Sanofi S.A.; Honoraria: Sanofi S.A. and MJH life sciences; Research Grant funding : MCW CTSI, AHW KL2 Award; J.G.B. received research support from Celgene, Takeda, BMS, Amgen, Janssen, Novarties, AbbVie, Bluebird Bio, Teva, Genetech/Roche, Poseida Therapeutics, Sanofi, Acetyon Pharmaceuticals, Lilly, Celularity, CRISPR Therapeutics, EMD Serono, Ichnos Sciences, GlaxoSmithKline, Incyte; honoraria from Takeda, BMS, CRISPR Therapeutics, Celgene, Kite, Janssen, Legend Biotech, Secura Bio and Bluebird Bio. L.J.C. received research support from BMS, Amgen and Janssen; honoraria from BMS, Janssen, Janssen, Sanofi, AbbVie, Adaptive biotechnologies. The remaining authors have no relevant conflict of interest to disclose.

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