{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T07:29:19Z","timestamp":1787038159373,"version":"build-2736575974"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"R\u00edo Hortega","award":["CM25\/00243"],"award-info":[{"award-number":["CM25\/00243"]}]},{"name":"R\u00edo Hortega","award":["CM25\/00250"],"award-info":[{"award-number":["CM25\/00250"]}]},{"name":"Juan Rod\u00e9s","award":["JR24\/00034"],"award-info":[{"award-number":["JR24\/00034"]}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Spanish Ministry of Science, Innovation and Universities"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bispecific antibodies (BsAbs) have revolutionized multiple myeloma (MM) treatment but are associated with infectious complications. This study aims to characterize the incidence, microbiological patterns, and risk factors for infection in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an observational cohort study of adult MM patients treated with BsAbs at a single center between 2020 and 2025. Clinical and microbiological features of different types of infection were analyzed. Risk factors for recurrent events were assessed by Cox regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 92 patients receiving 98 BsAb courses, 352 infectious episodes were identified (incidence rate: 3.20 episodes per BsAbs course-year). Most common syndromes were respiratory (71.3%) and digestive (11.9%), with predominant viral etiology (62.8%). Severe (grade \u22653) infections occurred in 45.9% of courses. Anti-BCMA BsAbs carried a higher infection risk than anti-GPRC5D therapy (aHR: 1.41, 95% CI: 1.02\u20131.94; P-value = 0.035). Previous BsAb exposure (aHR: 1.75, 95% CI: 1.23\u20132.50; P-value = 0.002), allogeneic hematopoietic stem-cell transplantation (aHR: 1.59, 95% CI: 1.12\u20132.26; P-value = 0.010), and development of immune effector cell-associated neurotoxicity syndrome (ICANS) (aHR: 3.23, 95% CI: 1.27\u20138.19; P-value = 0.001) increased the risk of infection. Intravenous immunoglobulin (IVIg) therapy was protective (aHR: 0.68, 95% CI: 0.53\u20130.86; P-value = 0.002). Concurrent infections were documented in only 6.8% of first episodes of cytokine release syndrome (CRS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BsAb therapy for MM is associated with a high infection burden, predominantly respiratory and gastrointestinal. Risk is driven by cumulative immunosuppression and therapy for ICANS, while IVIg therapy reduces this susceptibility. Infections are uncommon during CRS episodes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag505","type":"journal-article","created":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T11:35:34Z","timestamp":1786275334000},"source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology and Risk Factors for Infection in Multiple Myeloma Patients Treated With Bispecific Antibodies"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1497-8770","authenticated-orcid":false,"given":"Eduardo","family":"Aparicio-Minguij\u00f3n","sequence":"first","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12) , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0090-6673","authenticated-orcid":false,"given":"Nieves","family":"L\u00f3pez-Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), CNIO , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Bartolom\u00e9 Herguedas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario \u201c12 de Octubre\u201d , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo Jes\u00fas","family":"S\u00e1ez Mar\u00edn","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), CNIO , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0477-2337","authenticated-orcid":false,"given":"Mar\u00eda Asunci\u00f3n","family":"P\u00e9rez-Jacoiste As\u00edn","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12) , Madrid ,","place":["Spain"]},{"name":"Department of Medicine, School of Medicine, Universidad Complutense , Madrid ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"S\u00e1nchez-Pina","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), CNIO , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8106-4863","authenticated-orcid":false,"given":"Mar\u00eda","family":"Calbacho","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), CNIO , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2682-0819","authenticated-orcid":false,"given":"Jorge","family":"Bo\u00e1n","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12) , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5333-7529","authenticated-orcid":false,"given":"Francisco","family":"L\u00f3pez-Medrano","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12) , Madrid ,","place":["Spain"]},{"name":"Department of Medicine, School of Medicine, Universidad Complutense , Madrid ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3446-1991","authenticated-orcid":false,"given":"Rafael","family":"San Juan","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12) , Madrid ,","place":["Spain"]},{"name":"Department of Medicine, School of Medicine, Universidad Complutense , Madrid ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Tiago","family":"Silva","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12) , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaqu\u00edn","family":"Mart\u00ednez-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), CNIO , Madrid ,","place":["Spain"]},{"name":"Department of Medicine, School of Medicine, Universidad Complutense , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9520-8255","authenticated-orcid":false,"given":"Jos\u00e9 Mar\u00eda","family":"Aguado","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12) , Madrid ,","place":["Spain"]},{"name":"Department of Medicine, School of Medicine, Universidad Complutense , Madrid ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0315-8001","authenticated-orcid":false,"given":"Mario","family":"Fern\u00e1ndez-Ruiz","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12) , Madrid ,","place":["Spain"]},{"name":"Department of Medicine, School of Medicine, Universidad Complutense , Madrid ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2150-5748","authenticated-orcid":false,"given":"Isabel","family":"Rodr\u00edguez-Goncer","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12) , Madrid ,","place":["Spain"]},{"name":"Department of Medicine, School of Medicine, Universidad Complutense , Madrid ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"2026081803215417600_ofag505-B1","doi-asserted-by":"crossref","first-page":"3681","DOI":"10.1182\/blood.2021014611","article-title":"T-cell-redirecting bispecific antibodies in multiple myeloma: a revolution?","volume":"139","author":"Moreau","year":"2022","journal-title":"Blood"},{"key":"2026081803215417600_ofag505-B2","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/s13045-023-01489-3","article-title":"Bispecific antibodies targeting BCMA, GPRC5D, and FcRH5 for multiple myeloma therapy: latest updates from ASCO 2023 Annual Meeting","volume":"16","author":"Zhao","year":"2023","journal-title":"J Hematol Oncol"},{"key":"2026081803215417600_ofag505-B3","doi-asserted-by":"crossref","first-page":"5898","DOI":"10.1182\/bloodadvances.2023010539","article-title":"Infections following bispecific antibodies in myeloma: a systematic review and meta-analysis","volume":"7","author":"Reynolds","year":"2023","journal-title":"Blood Adv"},{"key":"2026081803215417600_ofag505-B4","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1182\/bloodadvances.2023011658","article-title":"Teclistamab impairs humoral immunity in patients with heavily pretreated myeloma: importance of immunoglobulin supplementation","volume":"8","author":"Frerichs","year":"2024","journal-title":"Blood 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