{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T03:03:49Z","timestamp":1791687829898,"version":"4.3.4"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Infections remain a major concern during treatment with bispecific T-cell engagers (BiTE) in hematological malignancies. The risk is primarily driven by disease- and treatment-related immunosuppression, as well as corticosteroid use during the early phase of therapy. It persists throughout the treatment course, requiring appropriate prophylactic measures. We report a real-world series of thirteen patients treated with BiTEs: 10 with multiple myeloma, two with refractory AL amyloidosis, and one with mantle cell lymphoma. During initial hospitalization, daily C-Reactive protein (CRP) monitoring was performed. Siltuximab, an anti-interleukin-6 monoclonal antibody, was administered instead of corticosteroids when CRP exceeded 40 mg\/L with a rapid 24-hour increase, based on predictive mathematical modeling, to preempt cytokine release syndrome (CRS). All patients received standard anti-infective prophylaxis, and treatment duration was adapted to clinical response. This approach was associated with only three grade 1\u20132 infections, indicating a favorable safety profile. These preliminary results support the design of a prospective multicenter study to evaluate the feasibility of home-based BiTE administration, integrating point-of-care testing, a digital health platform, and 24\/7 remote monitoring via a dedicated call center, within a comprehensive medico-economic framework.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1749348","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T05:22:40Z","timestamp":1770873760000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Targeted interleukin-6 blockade by siltuximab for cytokine release syndrome control and infection limitation in thirteen patients treated with bi-specific T-cell engagers"],"prefix":"10.3389","volume":"17","author":[{"given":"Jean-Fran\u00e7ois","family":"Rossi","sequence":"first","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine-Universit\u00e9 de Montpellier","place":["Montpellier, France"]},{"name":"Hematology Department, Institut du Cancer Avignon-Provence","place":["Avignon, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Cailleux","sequence":"additional","affiliation":[{"name":"Hematology Department, Institut du Cancer Avignon-Provence","place":["Avignon, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Wisnewski","sequence":"additional","affiliation":[{"name":"Hematology Department, Institut du Cancer Avignon-Provence","place":["Avignon, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Coussirou","sequence":"additional","affiliation":[{"name":"Hematology Department, Institut du Cancer Avignon-Provence","place":["Avignon, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7oise","family":"de Crozals","sequence":"additional","affiliation":[{"name":"Hematology Department, 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