Preventing and Managing Immunotherapy Infections in Myeloma

Myeloma specialist Dr. Joshua Richter from Mount Sinai, New York, shared ways of preventing and monitoring infections with revolutionary immune therapies for myeloma treatment at the 20th annual International Myeloma Society meeting. 

The Revolutionary Immunotherapies in Myeloma 

There have been 5 FDA myeloma immunotherapy approvals within the past two years, each with an unprecedented response rate within the myeloma population. 

These approvals were for both CAR-T products and bispecific antibody therapy: 

CAR T-Cell: 

• Cilta-cel
• Abecma 

Bispecific Antibody Therapy: 

• Teclistimab
• Elranatamab 
• Talquetamab 

Infections and Immunotherapies in Myeloma 

However, with these unprecedented response rates, we are also seeing infections on a large scale that are affecting myeloma patients in a variety of ways. There have been numerous infectious complications reported, and specialists are working diligently to provide appropriate preventative medicines to keep these infections at bay. 

The infections often present with lowered blood counts, hypogammaglobulinemia (a disorder caused by low serum immunoglobulin or antibody levels), and general inefficiency of the immune system to protect the host patient from common infections such as a cold or the flu, causing these common infections to become a real risk in terms of health and safety. 
 

Some of the prophylactic and responsive approaches that myeloma specialists are giving patients receiving CAR-T/bispecific antibodies at risk for serious infections are: 

• IVIG prophylaxis to prevent complications from hypogammaglobulinemia
• PJP prophylaxis 
• Monitoring for viral reactivations such as EBV and CMV to quickly identify and treat them accordingly  

Resources

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