Flat dose intravenous immunoglobulin primary infection prophylaxis in multiple myeloma patients on BCMA and GPRC5D bispecific antibody therapy: the Vanderbilt experience

Frontiers in Immunology 2026 Open access

Read full text
Authors: Naimisha Marneni, Spencer Lessans, Bhagirathbhai Dholaria, Salyka Sengsayadeth, Eden Biltibo, Vivek Patel, Shakthi Bhaskar, Reena Jayani, Sanjay Mohan, Ashwin Kishtagari, David Morgan, Olalekan O. Oluwole
+3 more Bipin N. Savani, Adetola Kassim, Muhamed Baljević
DOI: 10.3389/fimmu.2026.1721820
Cited by: 2
References: 15

Abstract

Bispecific antibodies (BsAbs) can cause profound hypogammaglobulinemia. Conventional infection prophylaxis has utilized weight-based IVIG dosing. However, the use of flat IVIG dosing can significantly reduce IVIG utilization. We evaluated hypogammaglobulinemia and infection risk in relapsed/refractory multiple myeloma (RRMM) patients treated with BsAbs who received flat-dose IVIG for primary infection prophylaxis. Among thirty patients, 73% had ≥1 and 43% had ≥2 infectious episodes. By severity, 27% of infections were CTCAE v5 grade three or higher and there were 2 sepsis-related deaths. Overall, flat-dose IVIG demonstrates feasibility for primary infection prophylaxis in RRMM patients receiving BsAbs.

Fields of Study & Subjects

Platelet Disorders and Treatments Immunodeficiency and Autoimmune Disorders Blood groups and transfusion

Publication details

Journal / source
Frontiers in Immunology
Publisher
Frontiers Media SA
Volume
17
Pages
1721820–1721820
Publication date
19 February 2026
Language
EN