Article Dans Une Revue Clinical Microbiology and Infection Année : 2024

Characteristics and incidence of infections in patients with multiple myeloma treated by bispecific antibodies: a national retrospective study

1 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
2 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
3 Hôtel-Dieu de Nantes
4 AP-HP - Hopital Saint-Louis [AP-HP]
5 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
6 CIIL - Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204
7 HUS - Les Hôpitaux Universitaires de Strasbourg
8 IRM - Immuno-Rhumatologie Moléculaire
9 ICANS - Institut de Cancérologie de Strasbourg Europe
10 Hôpital de la Croix-Rousse [CHU - HCL]
11 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
12 CIRI-LIB - Immuno-Biologie des Lymphomes [CIRI]
13 HCL - Hospices Civils de Lyon
14 Hôpital Necker - Enfants Malades [AP-HP]
15 IC UM3 (UMR 8104 / U1016) - Institut Cochin
16 Imagine - U1163 - Imagine - Institut des maladies génétiques (IHU)
17 CNRMA - Centre National de Référence Mycoses Invasives et Antifongiques - National Reference Center Invasive Mycoses & Antifungals
18 Mycologie translationnelle - Translational Mycology
19 CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux
20 CRCT - Centre de Recherches en Cancérologie de Toulouse
21 IPC - Institut Paoli-Calmettes
22 CIC-EC - Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques
23 LIPNESS - Lipides et transfert des lipides dans l'inflammation et le sepsis (CTM UMR 1231)
24 LabEx LipSTIC - Laboratoire d'Excellence : Lipoprotéines et Santé : prévention et Traitement des maladies Inflammatoires et du Cancer
25 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
26 CHU Clermont-Ferrand
27 Centre Hospitalier Saint Jean de Perpignan
28 Hôpital Côte de Nacre [CHU Caen]
29 CHU Caen
30 CHU Trousseau [Tours]
31 N2Cox - Niche, Nutrition, Cancer et métabolisme oxydatif
32 Infinity - Institut Toulousain des Maladies Infectieuses et Inflammatoires
Margaret Macro
  • Fonction : Auteur

Résumé

Objectives Bispecific antibodies (BsAbs) are an effective treatment used in relapsed or refractory multiple myeloma. Despite a well-tolerated safety profile, infectious events appear to be frequent in clinical trials. Real-world data on epidemiology, characteristics, risk factors, and outcomes of infections in patients treated with BsAb are still needed. Methods A retrospective, multicentre study in BsAb-treated patients with multiple myeloma was performed in 14 French centres from December 2020 to February 2023. The primary objective was to describe the incidence of infections that required hospitalization, specific treatment, or adaptation in BsAb administration. Results Among 229 patients with multiple myeloma treated with BsAb, 153 (67%) received teclistamab, 47 (20%) received elranatamab, and 29 (13%) talquetamab. We reported a total of 234 infections, including 123 (53%) of grade of ≥3. Predominant infections affected the respiratory tract (n = 116, 50%) followed by bacteraemias (n = 36, 15%). The hospitalization rate was 56% (n = 131), and 20 (9%) infections resulted in death. Global cumulative incidence of the first infection was 70% in all patients, 73% in patients treated with B-cell maturation antigen-targeting, and 51% with GPRC5D-targeting BsAb. In univariate analyses, corticosteroids for cytokine release syndrome (CRS)/immune effector cell-associated neurotoxicity syndrome (ICANS) were associated with a higher risk of first infection (HR = 2.13; 95% CI, 1.38–3.28), whereas GPRC5D-targeting BsAb and anti-bacterial prophylaxis were associated with a lower risk (HR = 0.53; 95% CI, 0.3–0.94 and HR = 0.65; 95% CI, 0.46–0.9). Fine and Gray multivariate model found that only corticosteroids for CRS/ICANS were correlated with a higher risk of first infection (HR = 2.01; 95% CI, 1.27–3.19). Discussions The implementation of preventive measures that aim to mitigate the risk of infection under BsAb is pivotal, notably in patients who received corticosteroids for CRS/ICANS.
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hal-04916309 , version 1 (28-01-2025)

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Aurélie Jourdes, Elise Cellerin, Cyrille Touzeau, Stéphanie Harel, Blandine Denis, et al.. Characteristics and incidence of infections in patients with multiple myeloma treated by bispecific antibodies: a national retrospective study. Clinical Microbiology and Infection, 2024, 30 (6), pp.764-771. ⟨10.1016/j.cmi.2024.02.023⟩. ⟨hal-04916309⟩
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