{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:11:39Z","timestamp":1792005099828,"version":"4.4.0"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Hematology"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Daratumumab (Dara) is generally well tolerated, but is associated with increased risk of infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We investigated hypogammaglobinemia occurrence in different Dara-based regimens. Multiple myeloma (MM) patients were treated with \u2a7e2 cycles of Dara-based therapy during 2016\u20132020, mainly for relapsed\/refractory disease. Data on patient characteristics, treatment regimens, polyclonal IgG (poly-IgG) and uninvolved free light chain (Un-FLC) levels during treatment, as well as predictors for hypogammaglobinemia and predictors for infections, were evaluated retrospectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 84 patients, median age 67.2\u2009years, were included. Dara, mainly as \u2a7e2 line therapy (88.1%, n\u2009=\u200974), was combined with immunomodulating drugs (IMiDs) (53%), proteasome inhibitors (PIs) (15%), IMiDs-PIs (11%), or dexamethasone only (21%). Median treatment duration was 13\u2009months. Median Poly-IgG levels at 0, 2, and 4\u2009months were 7.1\u2009g\/l, 4.5\u2009g\/l, and 4\u2009g\/l, respectively, and remained low throughout treatment. Lower poly-IgG pre-Dara ( p\u2009=\u20090.001) and Dara-PIs (\u00b1IMiDs) regimen were associated with lower poly-IgG levels at 4\u2009months ( p\u2009=\u20090.03). Only patients treated with Dara monotherapy had partial immune reconstitution, reflected by resumption of IgM levels. Most (85%) patients developed \u2a7e1 infections, mostly grade 1\u20132 respiratory (76%). A lower poly-IgG level post Dara (RR\u2009=\u20091.137 p\u2009=\u20090.026) predicted increased risk of any infection. Intravenous immunoglobulin (IVIG) was associated with a significant decrease in all infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Relapsed MM patients treated with Dara, often experience persistent hypogammaglobinemia, irrespective of responsiveness to treatment. Infections, especially respiratory, are frequent and apparently related to low Poly-IgG levels. IVIG should be considered for reducing infections in these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20406207211035272","type":"journal-article","created":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T09:02:26Z","timestamp":1627462946000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Daratumumab in combination with proteasome inhibitors, rapidly decreases polyclonal immunoglobulins and increases infection risk among relapsed multiple myeloma patients: a single center retrospective study"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9843-8817","authenticated-orcid":false,"given":"Roy","family":"Vitkon","sequence":"first","affiliation":[{"name":"Department of Hematology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street., Tel Aviv, 64239, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Netanely","sequence":"additional","affiliation":[{"name":"Department of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shai","family":"Levi","sequence":"additional","affiliation":[{"name":"Department of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomer","family":"Ziv-Baran","sequence":"additional","affiliation":[{"name":"School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronit","family":"Ben-Yzak","sequence":"additional","affiliation":[{"name":"The Hematology Laboratory, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben-Zion","family":"Katz","sequence":"additional","affiliation":[{"name":"The Hematology Laboratory, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noam","family":"Benyamini","sequence":"additional","affiliation":[{"name":"Department of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svetlana","family":"Trestman","sequence":"additional","affiliation":[{"name":"Department of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moshe","family":"Mittelman","sequence":"additional","affiliation":[{"name":"Department of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irit","family":"Avivi","sequence":"additional","affiliation":[{"name":"Department of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, 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