{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T19:35:14Z","timestamp":1793907314730,"version":"4.8.0"},"reference-count":161,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"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. Med."],"abstract":"<jats:p>Infections remain a major cause of morbidity and mortality in multiple myeloma (MM), driven by the interplay between disease-induced immune dysfunction and treatment-related immunosuppression. The introduction of proteasome inhibitors, immunomodulatory drugs, monoclonal antibodies, bispecific antibodies, and chimeric antigen receptor T (CAR-T) cell therapy has markedly improved survival while simultaneously reshaping the infectious risk landscape. Different treatment strategies compromise immunity in distinct mechanisms. Conventional chemotherapy and some targeted agents primarily increase the risk of bacterial infections through neutropenia. Modern immunotherapies, however, produce profound and prolonged hypogammaglobulinemia alongside cellular immune deficits, predisposing patients to viral reactivation and opportunistic infections. BCMA-targeting therapies (particularly bispecific antibodies and CAR-T cells) cause sustained plasma cell depletion and durable humoral immune impairment, resulting in an infection pattern that can persist well beyond treatment completion. Effective prevention requires a risk-stratified approach accounting for disease stage, treatment regimen, cumulative immunosuppression, and individual patient characteristics. This review synthesizes current evidence and provides practical, treatment-specific recommendations spanning infection risk assessment, pre-treatment screening, antimicrobial and antifungal prophylaxis, antiviral strategies, immunoglobulin replacement, granulocyte colony-stimulating factor use, and vaccination. Emphasis is placed on bispecific antibodies and CAR-T cell therapies, where infectious risk is greatest and prophylactic strategies are evolving most rapidly. Immunoglobulin replacement is highlighted as an increasingly relevant supportive strategy, with recent observational studies linking its use to marked reductions in serious infections and, among recipients of anti-BCMA bispecific antibodies, improved survival. This review provides clinicians with a practical framework for individualized infection prevention in the evolving therapeutic landscape of MM.<\/jats:p>","DOI":"10.3389\/fmed.2026.1847793","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T11:12:42Z","timestamp":1782817962000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Practical recommendations for infectious prophylaxis and vaccination in multiple myeloma patients"],"prefix":"10.3389","volume":"13","author":[{"given":"Rui","family":"Bergantim","sequence":"first","affiliation":[{"name":"Clinical Hematology Department, Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o","place":["Porto, Portugal"]},{"name":"Cancer Drug Resistance Group, Institute of Molecular Pathology and Immunology (IPATIMUP), Universidade do Porto","place":["Porto, Portugal"]},{"name":"i3S - Institute for Research and Innovation in Health, Universidade do Porto","place":["Porto, Portugal"]},{"name":"Hematological and Oncological Diseases Unit, Medicine Department, Faculty of Medicine of the University of Porto","place":["Porto, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Roque","sequence":"additional","affiliation":[{"name":"Clinical Hematology Department, Unidade Local de Sa\u00fade de Coimbra","place":["Coimbra, Portugal"]},{"name":"Physiology Institute, Faculdade de Medicina, Universidade de Coimbra","place":["Coimbra, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Jorge","sequence":"additional","affiliation":[{"name":"Clinical Hematology Department, Unidade Local de Sa\u00fade Lisboa Ocidental","place":["Lisbon, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Guilherme","family":"Freitas","sequence":"additional","affiliation":[{"name":"Clinical Hematology Department, Unidade Local de Sa\u00fade de Braga","place":["Braga, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Trigo Miranda","sequence":"additional","affiliation":[{"name":"Clinical Hematology Department, Hospital De S\u00e3o Teot\u00f3nio, Unidade Local de Sa\u00fade Viseu D\u00e3o-Laf\u00f5es","place":["Viseu, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Nunes","sequence":"additional","affiliation":[{"name":"Clinical Hematology Department, Unidade Local de Sa\u00fade Gaia e Espinho","place":["Vila Nova de Gaia, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Ionita","sequence":"additional","affiliation":[{"name":"Hematology Department, Instituto Portugu\u00eas de Oncologia Francisco Gentil de Lisboa","place":["Lisbon, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo","family":"Varanda Bernardo","sequence":"additional","affiliation":[{"name":"Hematology Department, Instituto Portugu\u00eas de Oncologia Francisco Gentil de Lisboa","place":["Lisbon, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana","family":"Vieira","sequence":"additional","affiliation":[{"name":"Hematology and Bone Marrow Transplantation Department, Unidade Local de Sa\u00fade de Santa Maria","place":["Lisbon, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliana","family":"Vale Aguiar","sequence":"additional","affiliation":[{"name":"Clinical Hematology Department, Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o","place":["Porto, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia","family":"Ferraz","sequence":"additional","affiliation":[{"name":"Hematology Department, Unidade Local de Sa\u00fade de Tr\u00e1s-Os-Montes e Alto Douro","place":["Vila Real, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Silva-Pinto","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o","place":["Porto, Portugal"]},{"name":"Infectious Diseases Unit, Medicine Department, Faculty of Medicine of the University of Porto","place":["Porto, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Bela","family":"Sarmento-Ribeiro","sequence":"additional","affiliation":[{"name":"Clinical Hematology Department, Unidade Local de Sa\u00fade de Coimbra","place":["Coimbra, Portugal"]},{"name":"Laboratory of Oncobiology and Hematology (LOH), University Clinics of Hematology and Oncology, Faculty of Medicine (FMUC), University of Coimbra","place":["Coimbra, Portugal"]},{"name":"Coimbra Institute for Clinical and Biomedical Research (iCBR)-Group of Environmental Genetics of Oncobiology (CIMAGO), FMUC, University of Coimbra","place":["Coimbra, Portugal"]},{"name":"Center for Innovative Biomedicine and Biotechnology (CIBB)","place":["Coimbra, Portugal"]},{"name":"Hematology Service, Centro Hospitalar Universit\u00e1rio de Coimbra, Unidade Local de Sa\u00fade de Coimbra","place":["Coimbra, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catarina","family":"Geraldes","sequence":"additional","affiliation":[{"name":"Clinical Hematology Department, Unidade Local de Sa\u00fade de Coimbra","place":["Coimbra, Portugal"]},{"name":"Laboratory of Oncobiology and Hematology (LOH), University Clinics of Hematology and Oncology, Faculty of Medicine (FMUC), University of Coimbra","place":["Coimbra, Portugal"]},{"name":"Coimbra Institute for Clinical and Biomedical Research (iCBR)-Group of Environmental Genetics of Oncobiology (CIMAGO), FMUC, University of Coimbra","place":["Coimbra, Portugal"]},{"name":"Center for Innovative Biomedicine and Biotechnology (CIBB)","place":["Coimbra, Portugal"]},{"name":"Hematology Service, Centro Hospitalar Universit\u00e1rio de Coimbra, Unidade Local de Sa\u00fade de Coimbra","place":["Coimbra, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Jo\u00e3o","sequence":"additional","affiliation":[{"name":"Hemato-Oncology Unit, Funda\u00e7\u00e3o Champalimaud","place":["Lisbon, Portugal"]},{"name":"NOVA Medical School, NOVA University of Lisbon","place":["Lisbon, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"163","DOI":"10.3324\/haematol.2024.285645","article-title":"Risk of infections in multiple myeloma. A populationbased study on 8,672 multiple myeloma patients diagnosed 2008-2021 from the Swedish myeloma registry","volume":"110","author":"Blimark","year":"2025","journal-title":"Haematologica"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1186\/s12885-021-08451-x","article-title":"Infection risks in multiple myeloma: a systematic review and meta-analysis of randomized trials from 2015 to 2019","volume":"21","author":"Balmaceda","year":"2021","journal-title":"BMC Cancer"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1016\/j.clml.2021.02.002","article-title":"Epidemiology and risks of infections in patients with multiple myeloma managed with new generation therapies","volume":"21","author":"Lim","year":"2021","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1007\/s00277-019-03621-1","article-title":"The risk of infections in multiple myeloma before and after the advent of novel agents: a 12-year survey","volume":"98","author":"Brioli","year":"2019","journal-title":"Ann Hematol"},{"key":"ref5","doi-asserted-by":"publisher","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":"ref6","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1038\/s41408-024-01043-5","article-title":"Comparison of infectious complications with BCMA-directed therapies in multiple myeloma","volume":"14","author":"Nath","year":"2024","journal-title":"Blood Cancer J"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"906","DOI":"10.3324\/haematol.2023.283590","article-title":"The changing spectrum of infection with BCMA and GPRC5D targeting bispecific antibody (bsAb) therapy in patients with relapsed refractory multiple myeloma","volume":"109","author":"Hammons","year":"2024","journal-title":"Haematologica"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"3069","DOI":"10.1182\/bloodadvances.2022009435","article-title":"Risk of infections associated with the use of bispecific antibodies in multiple myeloma: a pooled analysis","volume":"7","author":"Mazahreh","year":"2023","journal-title":"Blood Adv"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"107","DOI":"10.3324\/haematol.2014.107714","article-title":"Multiple myeloma and infections: a population-based study on 9253 multiple myeloma patients","volume":"100","author":"Blimark","year":"2015","journal-title":"Haematologica"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/cancers12040924","article-title":"PD-L1-PD-1 pathway in the pathophysiology of multiple myeloma","volume":"12","author":"Tamura","year":"2020","journal-title":"Cancers (Basel)"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/cancers13061221","article-title":"Boosting immunity against multiple myeloma","volume":"13","author":"Lopes","year":"2021","journal-title":"Cancers (Basel)"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1689","DOI":"10.1182\/blood-2018-01-825265","article-title":"TIGIT immune checkpoint blockade restores CD8(+) T-cell immunity against multiple myeloma","volume":"132","author":"Guillerey","year":"2018","journal-title":"Blood"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"S46","DOI":"10.1002\/ajh.26766","article-title":"Prevention of infections including vaccination strategies in multiple myeloma","volume":"98","author":"Ludwig","year":"2023","journal-title":"Am J Hematol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"2081","DOI":"10.1182\/blood.2025031744","article-title":"Immune biomarkers of increased infection risk in multiple myeloma","volume":"147","author":"Zabaleta","year":"2026","journal-title":"Blood"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"4771","DOI":"10.1158\/1078-0432.CCR-22-1594","article-title":"Circulating tumor and immune cells for minimally invasive risk stratification of smoldering multiple myeloma","volume":"28","author":"Termini","year":"2022","journal-title":"Clin Cancer Res"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e143","DOI":"10.1016\/S2352-3026(21)00283-0","article-title":"Consensus guidelines and recommendations for infection prevention in multiple myeloma: a report from the international myeloma working group","volume":"9","author":"Raje","year":"2022","journal-title":"Lancet Haematol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e171","DOI":"10.1016\/j.clml.2022.12.003","article-title":"Rates of influenza and pneumococcal vaccination and correlation with survival in multiple myeloma patients","volume":"23","author":"Thompson","year":"2023","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1063610","DOI":"10.3389\/fninf.2022.1063610","article-title":"Machine learning-based infection prediction model for newly diagnosed multiple myeloma patients","volume":"16","author":"Peng","year":"2022","journal-title":"Front Neuroinform"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/s00277-018-3465-8","article-title":"Glucocorticoids in multiple myeloma: past, present, and future","volume":"98","author":"Burwick","year":"2019","journal-title":"Ann Hematol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1182\/hematology.2020000116","article-title":"Practical approach to monitoring and prevention of infectious complications associated with systemic corticosteroids, antimetabolites, cyclosporine, and cyclophosphamide in nonmalignant hematologic diseases","volume":"2020","author":"Malpica","year":"2020","journal-title":"Hematology Am Soc Hematol Educ Program"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1038\/nri.2017.1","article-title":"Immune regulation by glucocorticoids","volume":"17","author":"Cain","year":"2017","journal-title":"Nat Rev Immunol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1111\/bjh.13532","article-title":"Risks, severity and timing of infections in patients with multiple myeloma: a longitudinal cohort study in the era of immunomodulatory drug therapy","volume":"171","author":"Teh","year":"2015","journal-title":"Br J Haematol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.blre.2019.01.001","article-title":"Management of infectious complications in multiple myeloma patients: expert panel consensus-based recommendations","volume":"34","author":"Girmenia","year":"2019","journal-title":"Blood Rev"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.1007\/s00277-023-05586-8","article-title":"Dismal prognosis of Pneumocystis jirovecii pneumonia in patients with multiple myeloma","volume":"103","author":"Riedhammer","year":"2024","journal-title":"Ann Hematol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/S1470-2045(09)70284-0","article-title":"Lenalidomide plus high-dose dexamethasone versus lenalidomide plus low-dose dexamethasone as initial therapy for newly diagnosed multiple myeloma: an open-label randomised controlled trial","volume":"11","author":"Rajkumar","year":"2010","journal-title":"Lancet Oncol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1038\/s41375-021-01488-8","article-title":"Daratumumab plus lenalidomide and dexamethasone in transplant-ineligible newly diagnosed multiple myeloma: frailty subgroup analysis of MAIA","volume":"36","author":"Facon","year":"2022","journal-title":"Leukemia"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.1016\/S1470-2045(25)00280-3","article-title":"Safety and efficacy of a dexamethasone-sparing regimen with daratumumab and lenalidomide in patients with frailty and newly diagnosed multiple myeloma (IFM2017-03): a phase 3, open-label, multicentre, randomised, controlled trial","volume":"26","author":"Manier","year":"2025","journal-title":"Lancet Oncol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/ph8010001","article-title":"Clinical use of proteasome inhibitors in the treatment of multiple myeloma","volume":"8","author":"Merin","year":"2014","journal-title":"Pharmaceuticals (Basel)"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"134","DOI":"10.3816\/CLML.2010.n.019","article-title":"Decrease in CD4+ T-cell counts in patients with multiple myeloma treated with bortezomib","volume":"10","author":"Heider","year":"2010","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1038\/leu.2009.236","article-title":"Mechanism of action of immunomodulatory drugs (IMiDS) in multiple myeloma","volume":"24","author":"Quach","year":"2010","journal-title":"Leukemia"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"2359","DOI":"10.1182\/blood-2017-01-725705","article-title":"How I manage the toxicities of myeloma drugs","volume":"129","author":"Delforge","year":"2017","journal-title":"Blood"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e30","DOI":"10.1016\/S2352-3026(25)00298-4","article-title":"Iberdomide plus low-dose cyclophosphamide and dexamethasone in patients with relapsed and refractory multiple myeloma (the ICON study): a multicentre, single-arm, phase 2 trial","volume":"13","author":"Korst","year":"2026","journal-title":"Lancet Haematol."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"7543","DOI":"10.1182\/blood-2025-7543","article-title":"Real-world efficacy and safety of mezigdomide-dexamethasone in heavily pre-treatred multiple myeloma patients: an Italian case series","volume":"146","author":"De Novellis","year":"2025","journal-title":"Blood"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1182\/blood-2009-05-221077","article-title":"Immunomodulatory derivatives induce PU.1 down-regulation, myeloid maturation arrest, and neutropenia","volume":"115","author":"Pal","year":"2010","journal-title":"Blood"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1182\/blood-2017-08-797886","article-title":"Safety and efficacy of selinexor in relapsed or refractory multiple myeloma and Waldenstrom macroglobulinemia","volume":"131","author":"Chen","year":"2018","journal-title":"Blood"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1177\/1060028019892643","article-title":"Selinexor: a first-in-class nuclear export inhibitor for management of multiply relapsed multiple myeloma","volume":"54","author":"Peterson","year":"2020","journal-title":"Ann Pharmacother"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1182\/blood-2017-06-740944","article-title":"CD38 antibodies in multiple myeloma: back to the future","volume":"131","author":"van de Donk","year":"2018","journal-title":"Blood"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1182\/blood-2015-12-687749","article-title":"Daratumumab depletes CD38+ immune regulatory cells, promotes T-cell expansion, and skews T-cell repertoire in multiple myeloma","volume":"128","author":"Krejcik","year":"2016","journal-title":"Blood"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"e302","DOI":"10.3324\/haematol.2019.231860","article-title":"Effect of daratumumab on normal plasma cells, polyclonal immunoglobulin levels, and vaccination responses in extensively pre-treated multiple myeloma patients","volume":"105","author":"Frerichs","year":"2020","journal-title":"Haematologica"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"2134","DOI":"10.3389\/fimmu.2018.02134","article-title":"CD38 antibodies in multiple myeloma: mechanisms of action and modes of resistance","volume":"9","author":"van de Donk","year":"2018","journal-title":"Front Immunol"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"ofac574","DOI":"10.1093\/ofid\/ofac574","article-title":"Cumulative incidence and relative risk of infection in patients with multiple myeloma treated with anti-CD38 monoclonal antibody-based regimens: a systematic review and meta-analysis","volume":"9","author":"Vassilopoulos","year":"2022","journal-title":"Open Forum Infect Dis"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1002\/jha2.46","article-title":"Efficacy of daratumumab combination regimen in patients with multiple myeloma: a combined analysis of phase III randomized controlled trials","volume":"1","author":"Htut","year":"2020","journal-title":"EJHaem"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1007\/s11523-021-00827-0","article-title":"Isatuximab: a review of its use in multiple myeloma","volume":"16","author":"Frampton","year":"2021","journal-title":"Target Oncol"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"817762","DOI":"10.3389\/fonc.2021.817762","article-title":"Practical considerations for the daratumumab management in Portuguese routine clinical practice: recommendations from an expert panel of hematologists","volume":"11","author":"Geraldes","year":"2021","journal-title":"Front Oncol"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"e1339853","DOI":"10.1080\/2162402X.2017.1339853","article-title":"The anti-SLAMF7 antibody elotuzumab mediates NK cell activation through both CD16-dependent and -independent mechanisms","volume":"6","author":"Pazina","year":"2017","journal-title":"Onco Targets Ther"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"7996","DOI":"10.4049\/jimmunol.175.12.7996","article-title":"The cytotoxicity receptor CRACC (CS-1) recruits EAT-2 and activates the PI3K and phospholipase Cgamma signaling pathways in human NK cells","volume":"175","author":"Tassi","year":"2005","journal-title":"J Immunol"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1056\/NEJMoa1505654","article-title":"Elotuzumab therapy for relapsed or refractory multiple myeloma","volume":"373","author":"Lonial","year":"2015","journal-title":"N Engl J Med"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"1811","DOI":"10.1056\/NEJMoa1805762","article-title":"Elotuzumab plus Pomalidomide and dexamethasone for multiple myeloma","volume":"379","author":"Dimopoulos","year":"2018","journal-title":"N Engl J Med"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1080\/14737140.2023.2169139","article-title":"Safety and efficacy of Elotuzumab combination therapy for patients with multiple myeloma: a systematic review and meta-analysis","volume":"23","author":"Noori","year":"2023","journal-title":"Expert Rev Anticancer Ther"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"S22","DOI":"10.1002\/ajh.26750","article-title":"Antibody drug conjugates for the treatment of multiple myeloma","volume":"98","author":"Leong","year":"2023","journal-title":"Am J Hematol"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1056\/NEJMoa2403407","article-title":"Belantamab mafodotin, pomalidomide, and dexamethasone in multiple myeloma","volume":"391","author":"Dimopoulos","year":"2024","journal-title":"N Engl J Med"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1056\/NEJMoa2405090","article-title":"Belantamab mafodotin, bortezomib, and dexamethasone for multiple myeloma","volume":"391","author":"Hungria","year":"2024","journal-title":"N Engl J Med"},{"key":"ref53","doi-asserted-by":"publisher","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":"ref54","doi-asserted-by":"publisher","first-page":"e2238961","DOI":"10.1001\/jamanetworkopen.2022.38961","article-title":"Kinetics of humoral immunodeficiency with bispecific antibody therapy in relapsed refractory multiple myeloma","volume":"5","author":"Hammons","year":"2022","journal-title":"JAMA Netw Open"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1016\/j.cmi.2024.02.023","article-title":"Characteristics and incidence of infections in patients with multiple myeloma treated by bispecific antibodies: a national retrospective study","volume":"30","author":"Jourdes","year":"2024","journal-title":"Clin Microbiol Infect"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"2466","DOI":"10.1182\/bloodadvances.2021006178","article-title":"Risk of infections with B-cell maturation antigen-directed immunotherapy in multiple myeloma","volume":"6","author":"Mohan","year":"2022","journal-title":"Blood Adv"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1038\/s41408-023-00879-7","article-title":"Monitoring, prophylaxis, and treatment of infections in patients with MM receiving bispecific antibody therapy: consensus recommendations from an expert panel","volume":"13","author":"Raje","year":"2023","journal-title":"Blood Cancer J"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/cancers15061819","article-title":"Bispecific antibodies in multiple myeloma: opportunities to enhance efficacy and improve safety","volume":"15","author":"Swan","year":"2023","journal-title":"Cancers (Basel)"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1182\/blood.2022015956","article-title":"T-cell exhaustion induced by continuous bispecific molecule exposure is ameliorated by treatment-free intervals","volume":"140","author":"Philipp","year":"2022","journal-title":"Blood"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1038\/s41375-020-0734-z","article-title":"B-cell maturation antigen (BCMA) in multiple myeloma: rationale for targeting and current therapeutic approaches","volume":"34","author":"Shah","year":"2020","journal-title":"Leukemia"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"119","DOI":"10.2147\/BLCTT.S327016","article-title":"CAR T-cell therapy for patients with multiple myeloma: current evidence and challenges","volume":"12","author":"Rendo","year":"2022","journal-title":"Blood Lymphat Cancer"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1056\/NEJMoa2303379","article-title":"Cilta-cel or standard care in lenalidomide-refractory multiple myeloma","volume":"389","author":"San-Miguel","year":"2023","journal-title":"N Engl J Med"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"5290","DOI":"10.1182\/bloodadvances.2021004603","article-title":"Humoral immune reconstitution after anti-BCMA CAR T-cell therapy in relapsed\/refractory multiple myeloma","volume":"5","author":"Wang","year":"2021","journal-title":"Blood Adv"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1111\/bjh.18909","article-title":"Recommendations on prevention of infections during chimeric antigen receptor T-cell and bispecific antibody therapy in multiple myeloma","volume":"203","author":"Mohan","year":"2023","journal-title":"Br J Haematol"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"2045","DOI":"10.1182\/bloodadvances.2020004079","article-title":"Infectious complications in patients with relapsed refractory multiple myeloma after BCMA CAR T-cell therapy","volume":"6","author":"Thiruvengadam","year":"2022","journal-title":"Blood Adv"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"1370","DOI":"10.1182\/bloodadvances.2024015008","article-title":"Characteristics of infections after BCMA-directed CAR T-cell therapy for multiple myeloma: a real-world analysis","volume":"9","author":"Richardson","year":"2025","journal-title":"Blood Adv"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"e7372","DOI":"10.1002\/cam4.7372","article-title":"Infections associated with CAR-T cell therapy in patients with relapsed refractory multiple myeloma: risks and prevention strategies","volume":"13","author":"An","year":"2024","journal-title":"Cancer Med"},{"key":"ref68","doi-asserted-by":"publisher","first-page":"e28","DOI":"10.3324\/haematol.2014.114025","article-title":"Invasive fungal infections in patients with multiple myeloma: a multi-center study in the era of novel myeloma therapies","volume":"100","author":"Teh","year":"2015","journal-title":"Haematologica"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1186\/s40425-018-0343-9","article-title":"Cytokine release syndrome","volume":"6","author":"Shimabukuro-Vornhagen","year":"2018","journal-title":"J Immunother Cancer"},{"key":"ref70","doi-asserted-by":"publisher","first-page":"6109","DOI":"10.1182\/bloodadvances.2022008320","article-title":"Early cytopenias and infections after standard of care idecabtagene vicleucel in relapsed or refractory multiple myeloma","volume":"6","author":"Logue","year":"2022","journal-title":"Blood Adv"},{"key":"ref71","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1016\/S0140-6736(21)00933-8","article-title":"Ciltacabtagene autoleucel, a B-cell maturation antigen-directed chimeric antigen receptor T-cell therapy in patients with relapsed or refractory multiple myeloma (CARTITUDE-1): a phase 1b\/2 open-label study","volume":"398","author":"Berdeja","year":"2021","journal-title":"Lancet"},{"key":"ref72","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1056\/NEJMoa2024850","article-title":"Idecabtagene vicleucel in relapsed and refractory multiple myeloma","volume":"384","author":"Munshi","year":"2021","journal-title":"N Engl J Med"},{"key":"ref73","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1038\/s41409-022-01756-w","article-title":"Infectious complications, immune reconstitution, and infection prophylaxis after CD19 chimeric antigen receptor T-cell therapy","volume":"57","author":"Wudhikarn","year":"2022","journal-title":"Bone Marrow Transplant"},{"key":"ref74","doi-asserted-by":"publisher","first-page":"2087","DOI":"10.1200\/JCO.22.01365","article-title":"Idecabtagene Vicleucel for relapsed\/refractory multiple myeloma: real-world experience from the myeloma CAR T consortium","volume":"41","author":"Hansen","year":"2023","journal-title":"J Clin Oncol"},{"key":"ref75","doi-asserted-by":"publisher","first-page":"2613505","DOI":"10.1080\/16078454.2026.2613505","article-title":"The efficacy and safety of CAR-T therapy in relapsed or refractory multiple myeloma patients: a systematic review and meta-analysis","volume":"31","author":"Zhou","year":"2026","journal-title":"Hematology"},{"key":"ref76","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1111\/ejh.13190","article-title":"Risk factors for infections in newly diagnosed multiple myeloma patients: a Danish retrospective nationwide cohort study","volume":"102","author":"S\u00f8rrig","year":"2019","journal-title":"Eur J Haematol"},{"key":"ref77","doi-asserted-by":"publisher","first-page":"2517","DOI":"10.1038\/leu.2012.124","article-title":"Oral antibiotic prophylaxis of early infection in multiple myeloma: a URCC\/ECOG randomized phase III study","volume":"26","author":"Vesole","year":"2012","journal-title":"Leukemia"},{"key":"ref78","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1016\/S0002-9343(95)00043-7","article-title":"Prophylactic antibiotics for the prevention of early infection in multiple myeloma","volume":"100","author":"Oken","year":"1996","journal-title":"Am J Med"},{"key":"ref79","doi-asserted-by":"publisher","first-page":"1760","DOI":"10.1016\/S1470-2045(19)30506-6","article-title":"Levofloxacin prophylaxis in patients with newly diagnosed myeloma (TEAMM): a multicentre, double-blind, placebo-controlled, randomised, phase 3 trial","volume":"20","author":"Drayson","year":"2019","journal-title":"Lancet Oncol"},{"key":"ref80","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1111\/ejh.13374","article-title":"Antibiotic prophylaxis for patients with newly diagnosed multiple myeloma: systematic review and meta-analysis","volume":"104","author":"Mohyuddin","year":"2020","journal-title":"Eur J Haematol"},{"key":"ref81","doi-asserted-by":"publisher","first-page":"e56","DOI":"10.1093\/cid\/cir073","article-title":"Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america","volume":"52","author":"Freifeld","year":"2011","journal-title":"Clin Infect Dis"},{"key":"ref82","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1016\/j.bbmt.2009.06.019","article-title":"Guidelines for preventing infectious complications among hematopoietic cell transplantation recipients: a global perspective","volume":"15","author":"Tomblyn","year":"2009","journal-title":"Biol Blood Marrow Transplant"},{"key":"ref83","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1111\/ejh.12813","article-title":"Epidemiology of bloodstream infections in patients with myeloma receiving current era therapy","volume":"98","author":"Teh","year":"2017","journal-title":"Eur J Haematol"},{"key":"ref84","doi-asserted-by":"publisher","first-page":"2397","DOI":"10.1093\/jac\/dkw157","article-title":"ECIL guidelines for preventing pneumocystis jirovecii pneumonia in patients with haematological malignancies and stem cell transplant recipients","volume":"71","author":"Maertens","year":"2016","journal-title":"J Antimicrob Chemother"},{"key":"ref85","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.1086\/605664","article-title":"Infections in patients with multiple myeloma in the era of high-dose therapy and novel agents","volume":"49","author":"Nucci","year":"2009","journal-title":"Clin Infect Dis"},{"key":"ref86","doi-asserted-by":"publisher","first-page":"3043","DOI":"10.1200\/JCO.18.00374","article-title":"Antimicrobial prophylaxis for adult patients with cancer-related immunosuppression: ASCO and IDSA clinical practice guideline update","volume":"36","author":"Taplitz","year":"2018","journal-title":"J Clin Oncol"},{"key":"ref87","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1182\/hematology.2024000535","article-title":"Mitigating and managing infection risk in adults treated with CAR T-cell therapy","volume":"2024","author":"Tabbara","year":"2024","journal-title":"Hematology Am Soc Hematol Educ Program"},{"key":"ref88","doi-asserted-by":"publisher","first-page":"2598","DOI":"10.1080\/10428194.2017.1312369","article-title":"Risk and impact of tuberculosis in patients with multiple myeloma","volume":"58","author":"Tsai","year":"2017","journal-title":"Leuk Lymphoma"},{"key":"ref89","doi-asserted-by":"publisher","first-page":"e359","DOI":"10.1016\/S1473-3099(22)00227-4","article-title":"Mycobacterial infections in adults with haematological malignancies and haematopoietic stem cell transplants: guidelines from the 8th European conference on infections in leukaemia","volume":"22","author":"Bergeron","year":"2022","journal-title":"Lancet Infect Dis"},{"key":"ref90","doi-asserted-by":"publisher","first-page":"2487","DOI":"10.1056\/NEJMoa043445","article-title":"Bortezomib or high-dose dexamethasone for relapsed multiple myeloma","volume":"352","author":"Richardson","year":"2005","journal-title":"N Engl J Med"},{"key":"ref91","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1056\/NEJMoa1606038","article-title":"Daratumumab, Bortezomib, and dexamethasone for multiple myeloma","volume":"375","author":"Palumbo","year":"2016","journal-title":"N Engl J Med"},{"key":"ref92","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1200\/JCO.2003.03.139","article-title":"Thalidomide alone or with dexamethasone for previously untreated multiple myeloma","volume":"21","author":"Weber","year":"2003","journal-title":"J Clin Oncol"},{"key":"ref93","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1016\/S1665-2681(19)30855-5","article-title":"Hepatitis B reactivation in patients with multiple myeloma and isolated positive hepatitis B core antibody: a call for greater cognizance","volume":"13","author":"Yang","year":"2014","journal-title":"Ann Hepatol"},{"key":"ref94","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/cancers11111819","article-title":"Reactivation of hepatitis B virus in patients with multiple myeloma","volume":"11","author":"Tsukune","year":"2019","journal-title":"Cancers (Basel)"},{"key":"ref95","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1016\/j.jtct.2024.07.018","article-title":"Best practice considerations by the American Society of Transplant and Cellular Therapy: infection prevention and management after chimeric antigen receptor T cell therapy for hematological malignancies","volume":"30","author":"Shahid","year":"2024","journal-title":"Transplant Cell Ther"},{"key":"ref96","doi-asserted-by":"publisher","first-page":"e597","DOI":"10.1097\/HS9.0000000000000597","article-title":"Compliance with vaccination recommendations among patients with multiple myeloma: a real world experience","volume":"5","author":"Ludwig","year":"2021","journal-title":"Hema"},{"key":"ref97","doi-asserted-by":"publisher","first-page":"1465","DOI":"10.1007\/s00277-016-2742-7","article-title":"Incidence and clinical background of hepatitis B virus reactivation in multiple myeloma in novel agents' era","volume":"95","author":"Tsukune","year":"2016","journal-title":"Ann Hematol"},{"key":"ref98","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1016\/j.jhep.2025.03.018","article-title":"EASL clinical practice guidelines on the management of hepatitis B virus infection","volume":"83","author":"Cornberg","year":"2025","journal-title":"J Hepatol"},{"key":"ref99","doi-asserted-by":"publisher","first-page":"2212","DOI":"10.1200\/JCO.2015.61.3745","article-title":"Hepatitis B virus screening for patients with Cancer before therapy: American Society of Clinical Oncology provisional clinical opinion update","volume":"33","author":"Hwang","year":"2015","journal-title":"J Clin Oncol"},{"key":"ref100","doi-asserted-by":"publisher","first-page":"1434","DOI":"10.1128\/JCM.03546-14","article-title":"Reactivation of hepatitis B virus without core antibody","volume":"53","author":"Silva-Pinto","year":"2015","journal-title":"J Clin Microbiol"},{"key":"ref101","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1016\/j.jhep.2017.03.021","article-title":"EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection","volume":"67","author":"Lampertico","year":"2017","journal-title":"J Hepatol"},{"key":"ref102","doi-asserted-by":"publisher","first-page":"ofv211","DOI":"10.1093\/ofid\/ofv211","article-title":"Management of multiple myeloma complicated by hepatitis C virus reactivation: the role of new antiviral therapy","volume":"3","author":"Mahale","year":"2016","journal-title":"Open Forum Infect Dis"},{"key":"ref103","doi-asserted-by":"publisher","first-page":"1170","DOI":"10.1016\/j.jhep.2020.08.018","article-title":"EASL recommendations on treatment of hepatitis C: final update of the series(\u2606)","volume":"73","author":"Pawlotsky","year":"2020","journal-title":"J Hepatol"},{"key":"ref104","doi-asserted-by":"publisher","first-page":"3221","DOI":"10.1093\/jac\/dky286","article-title":"European guidelines for primary antifungal prophylaxis in adult haematology patients: summary of the updated recommendations from the European conference on infections in Leukaemia","volume":"73","author":"Maertens","year":"2018","journal-title":"J Antimicrob Chemother"},{"key":"ref105","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1086\/313592","article-title":"Invasive aspergillosis as an opportunistic infection in nonallografted patients with multiple myeloma: a European Organization for Research and Treatment of Cancer\/ invasive fungal infections cooperative group and the Intergroupe Fran\u00e7ais du My\u00e9lome","volume":"30","author":"Lortholary","year":"2000","journal-title":"Clin Infect Dis"},{"key":"ref106","doi-asserted-by":"publisher","first-page":"1813","DOI":"10.1093\/jac\/dkad143","article-title":"Primary prophylaxis of invasive fungal diseases in patients with haematological malignancies: 2022 update of the recommendations of the infectious diseases working party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO)","volume":"78","author":"Stemler","year":"2023","journal-title":"J Antimicrob Chemother"},{"key":"ref107","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1086\/515128","article-title":"Randomized placebo-controlled trial of fluconazole prophylaxis for neutropenic cancer patients: benefit based on purpose and intensity of cytotoxic therapy. The Canadian fluconazole prophylaxis study group","volume":"28","author":"Rotstein","year":"1999","journal-title":"Clin Infect Dis"},{"key":"ref108","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1182\/blood.2019004000","article-title":"How I prevent infections in patients receiving CD19-targeted chimeric antigen receptor T cells for B-cell malignancies","volume":"136","author":"Hill","year":"2020","journal-title":"Blood"},{"key":"ref109","doi-asserted-by":"publisher","first-page":"2379","DOI":"10.1093\/jac\/dkw155","article-title":"Pneumocystis jirovecii pneumonia: still a concern in patients with haematological malignancies and stem cell transplant recipients","volume":"71","author":"Cordonnier","year":"2016","journal-title":"J Antimicrob Chemother"},{"key":"ref110","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1002\/hon.3185","article-title":"Intravenous immunoglobulin prophylaxis is associated with decreased rate of infection-related hospitalizations in multiple myeloma patients","volume":"41","author":"Sheu","year":"2023","journal-title":"Hematol Oncol"},{"key":"ref111","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1182\/blood-2020-140056","article-title":"Effect of intravenous immunoglobulin on infections in multiple myeloma (MM) patients receiving daratumumab","volume":"136","author":"Lancman","year":"2020","journal-title":"Blood"},{"key":"ref112","doi-asserted-by":"publisher","first-page":"4757","DOI":"10.1182\/blood-2021-147622","article-title":"Variation in use of immunoglobulin and impact on survival in multiple myeloma: a report from the Australian and New Zealand myeloma and related diseases registry (MRDR)","volume":"138","author":"Chai","year":"2021","journal-title":"Blood"},{"key":"ref113","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1038\/s41408-026-01451-9","article-title":"Immunoglobulin supplementation and longer dosing intervals reduce risk of infections in patients with RRMM treated with teclistamab","volume":"16","author":"Smits","year":"2026","journal-title":"Blood Cancer J"},{"key":"ref114","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1503\/cmaj.130375","article-title":"Intravenous immunoglobulin as clinical immune-modulating therapy","volume":"187","author":"Gilardin","year":"2015","journal-title":"CMAJ"},{"key":"ref115","doi-asserted-by":"publisher","first-page":"15","DOI":"10.3390\/biom6010015","article-title":"The production processes and biological effects of intravenous immunoglobulin","volume":"6","author":"Barahona Afonso","year":"2016","journal-title":"Biomolecules"},{"key":"ref116","doi-asserted-by":"publisher","first-page":"3131","DOI":"10.1182\/blood-2019-127247","article-title":"Hypogammaglobulinemia and its implications in patients treated with daratumumab: a single institution experience","volume":"134","author":"Paul","year":"2019","journal-title":"Blood"},{"key":"ref117","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1158\/2643-3230.BCD-23-0049","article-title":"IVIg use associated with ten-fold reduction of serious infections in multiple myeloma patients treated with anti-BCMA bispecific antibodies","volume":"4","author":"Lancman","year":"2023","journal-title":"Blood Cancer Discov"},{"key":"ref118","doi-asserted-by":"publisher","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 Adv"},{"key":"ref119","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1038\/s41408-025-01282-0","article-title":"Effect of intravenous immunoglobulin (IVIG) supplementation on infection-free survival in recipients of BCMA-directed bispecific antibody therapy for multiple myeloma","volume":"15","author":"Mohan","year":"2025","journal-title":"Blood Cancer J"},{"key":"ref120","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.clim.2017.11.014","article-title":"Subcutaneous immunoglobulins in patients with multiple myeloma and secondary hypogammaglobulinemia: a randomized trial","volume":"191","author":"Vacca","year":"2018","journal-title":"Clin Immunol"},{"key":"ref121","doi-asserted-by":"publisher","first-page":"4720","DOI":"10.1182\/bloodadvances.2025016490","article-title":"Immunoglobulin prophylaxis should be initiated after bispecific antibody therapy in multiple myeloma, regardless of IgG levels","volume":"9","author":"Banerjee","year":"2025","journal-title":"Blood Adv"},{"key":"ref122","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1038\/s41375-020-01016-0","article-title":"Recommendations for vaccination in multiple myeloma: a consensus of the European myeloma network","volume":"35","author":"Ludwig","year":"2021","journal-title":"Leukemia"},{"key":"ref123","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1182\/bloodadvances.2025018127","article-title":"Vaccination should not be forgotten in patients receiving immunoglobulin replacement therapy","volume":"10","author":"Einarsdottir","year":"2026","journal-title":"Blood Adv"},{"key":"ref124","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1182\/bloodadvances.2025018225","article-title":"Vaccination during bispecific antibody treatment for myeloma","volume":"10","author":"Banerjee","year":"2026","journal-title":"Blood Adv"},{"key":"ref125","doi-asserted-by":"publisher","first-page":"3038","DOI":"10.1200\/JCO.2000.18.16.3038","article-title":"The multinational Association for Supportive Care in Cancer risk index: a multinational scoring system for identifying low-risk febrile neutropenic cancer patients","volume":"18","author":"Klastersky","year":"2000","journal-title":"J Clin Oncol"},{"key":"ref126","doi-asserted-by":"publisher","first-page":"1860","DOI":"10.1056\/NEJMra041875","article-title":"Multiple myeloma","volume":"351","author":"Kyle","year":"2004","journal-title":"N Engl J Med"},{"key":"ref127","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.blre.2011.03.005","article-title":"Practical management of adverse events in multiple myeloma: can therapy be attenuated in older patients?","volume":"25","author":"Palumbo","year":"2011","journal-title":"Blood Rev"},{"key":"ref128","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.clml.2011.11.001","article-title":"How to manage neutropenia in multiple myeloma","volume":"12","author":"Palumbo","year":"2012","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"ref129","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1056\/NEJMoa0801479","article-title":"Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma","volume":"359","author":"San Miguel","year":"2008","journal-title":"N Engl J Med"},{"key":"ref130","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1111\/j.1365-2141.2005.05519.x","article-title":"PAD combination therapy (PS-341\/bortezomib, doxorubicin and dexamethasone) for previously untreated patients with multiple myeloma","volume":"129","author":"Oakervee","year":"2005","journal-title":"Br J Haematol"},{"key":"ref131","doi-asserted-by":"publisher","first-page":"E232","DOI":"10.1002\/ajh.25858","article-title":"Phase I\/II study of high dose pomalidomide with G-CSF support and dexamethasone in patients with relapsed\/refractory multiple myeloma","volume":"95","author":"Manasanch","year":"2020","journal-title":"Am J Hematol"},{"key":"ref132","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.6004\/jnccn.2013.0148","article-title":"Myeloid growth factors","volume":"11","author":"Crawford","year":"2013","journal-title":"J Natl Compr Cancer Netw"},{"key":"ref133","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1182\/blood-2014-05-552729","article-title":"Current concepts in the diagnosis and management of cytokine release syndrome","volume":"124","author":"Lee","year":"2014","journal-title":"Blood"},{"key":"ref134","doi-asserted-by":"publisher","first-page":"2347","DOI":"10.1038\/s41409-020-01006-x","article-title":"G-CSF does not worsen toxicities and efficacy of CAR-T cells in refractory\/relapsed B-cell lymphoma","volume":"55","author":"Galli","year":"2020","journal-title":"Bone Marrow Transplant"},{"key":"ref135","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1038\/s41409-021-01526-0","article-title":"Effect of early granulocyte-colony-stimulating factor administration in the prevention of febrile neutropenia and impact on toxicity and efficacy of anti-CD19 CAR-T in patients with relapsed\/refractory B-cell lymphoma","volume":"57","author":"Li\u00e9vin","year":"2022","journal-title":"Bone Marrow Transplant"},{"key":"ref136","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1111\/ejh.70013","article-title":"Vaccination in multiple myeloma: challenges and strategies","volume":"115","author":"Martino","year":"2025","journal-title":"Eur J Haematol"},{"key":"ref137","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1016\/j.clml.2017.02.025","article-title":"Clinical and serologic responses after a two-dose series of high-dose influenza vaccine in plasma cell disorders: a prospective, single-arm trial","volume":"17","author":"Branagan","year":"2017","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"ref138","doi-asserted-by":"publisher","first-page":"53","DOI":"10.17294\/2330-0698.1415","article-title":"Multiple myeloma vaccination patterns in a large health system: a pilot study","volume":"4","author":"Alemu","year":"2017","journal-title":"J Patient Cent Res Rev"},{"key":"ref139","doi-asserted-by":"publisher","first-page":"e183267","DOI":"10.1001\/jamaoncol.2018.3267","article-title":"Assessment of safety and immunogenicity of PVX-410 vaccine with or without lenalidomide in patients with smoldering multiple myeloma: a nonrandomized clinical trial","volume":"4","author":"Nooka","year":"2018","journal-title":"JAMA Oncol"},{"key":"ref140","doi-asserted-by":"publisher","first-page":"1741","DOI":"10.2147\/CIA.S220423","article-title":"Immunogenicity and safety of the 13-valent pneumococcal conjugate vaccine in patients with monoclonal Gammopathy of undetermined significance - relationship with selected immune and clinical parameters","volume":"14","author":"Pasiarski","year":"2019","journal-title":"Clin Interv Aging"},{"key":"ref141","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1038\/sj.bmt.1705381","article-title":"Rapid helper T-cell recovery above 200 x 10 6\/l at 3 months correlates to successful transplant outcomes after allogeneic stem cell transplantation","volume":"37","author":"Kim","year":"2006","journal-title":"Bone Marrow Transplant"},{"key":"ref142","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.1016\/j.ccell.2021.06.014","article-title":"Highly variable SARS-CoV-2 spike antibody responses to two doses of COVID-19 RNA vaccination in patients with multiple myeloma","volume":"39","author":"Van Oekelen","year":"2021","journal-title":"Cancer Cell"},{"key":"ref143","doi-asserted-by":"publisher","first-page":"3057","DOI":"10.1200\/JCO.21.02257","article-title":"Determinants of neutralizing antibody response after SARS CoV-2 vaccination in patients with myeloma","volume":"40","author":"Nooka","year":"2022","journal-title":"J Clin Oncol"},{"key":"ref144","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1016\/j.bbmt.2017.12.795","article-title":"Revaccination after autologous hematopoietic stem cell transplantation is safe and effective in patients with multiple myeloma receiving Lenalidomide maintenance","volume":"24","author":"Palazzo","year":"2018","journal-title":"Biol Blood Marrow Transplant"},{"key":"ref145","doi-asserted-by":"publisher","first-page":"1426","DOI":"10.1158\/1078-0432.CCR-11-1221","article-title":"Lenalidomide-induced immunomodulation in multiple myeloma: impact on vaccines and antitumor responses","volume":"18","author":"Noonan","year":"2012","journal-title":"Clin Cancer Res"},{"key":"ref146","doi-asserted-by":"publisher","first-page":"1605","DOI":"10.1182\/blood-2010-04-278432","article-title":"The immunostimulatory effect of lenalidomide on NK-cell function is profoundly inhibited by concurrent dexamethasone therapy","volume":"117","author":"Hsu","year":"2011","journal-title":"Blood"},{"key":"ref147","doi-asserted-by":"publisher","first-page":"e446","DOI":"10.1016\/S2352-3026(21)00057-0","article-title":"CAR T-cell therapy for multiple myeloma: state of the art and prospects","volume":"8","author":"van de Donk","year":"2021","journal-title":"Lancet Haematol."},{"key":"ref148","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41467-026-71473-1","article-title":"Influence of B cell-lineage targeted CAR-T cell therapy on humoral immunity and vaccine-induced antibody response","volume":"17","author":"Ozog","year":"2026","journal-title":"Nat Commun"},{"key":"ref149","doi-asserted-by":"publisher","first-page":"e14145","DOI":"10.1111\/tid.14145","article-title":"The shifting roles and toxicities of cellular therapies in B-cell malignancies","volume":"25","author":"Makos","year":"2023","journal-title":"Transpl Infect Dis"},{"key":"ref150","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1111\/tid.14109","article-title":"Vaccine schedule recommendations and updates for patients with hematologic malignancy post-hematopoietic cell transplant or CAR T-cell therapy","volume":"25","author":"Reynolds","year":"2023","journal-title":"Transpl Infect Dis"},{"key":"ref151","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.1016\/S0140-6736(17)33293-2","article-title":"Estimates of global seasonal influenza-associated respiratory mortality: a modelling study","volume":"391","author":"Iuliano","year":"2018","journal-title":"Lancet"},{"key":"ref152","doi-asserted-by":"publisher","first-page":"e285","DOI":"10.3324\/haematol.2014.116772","article-title":"Efficacy of single versus boost vaccination against influenza virus in patients with multiple myeloma","volume":"100","author":"Hahn","year":"2015","journal-title":"Haematologica"},{"key":"ref153","doi-asserted-by":"publisher","first-page":"307","DOI":"10.3324\/haematol.2010.032664","article-title":"Repeated vaccination is required to optimize seroprotection against H1N1 in the immunocompromised host","volume":"96","author":"de Lavallade","year":"2011","journal-title":"Haematologica"},{"key":"ref154","doi-asserted-by":"publisher","first-page":"2434","DOI":"10.1016\/j.cell.2022.05.022","article-title":"Humoral and cellular immune memory to four COVID-19 vaccines","volume":"185","author":"Zhang","year":"2022","journal-title":"Cell"},{"key":"ref155","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1016\/j.clml.2023.03.002","article-title":"Response to COVID-19 vaccination post-CAR T therapy in patients with non-Hodgkin lymphoma and multiple myeloma","volume":"23","author":"Wiedmeier-Nutor","year":"2023","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"ref156","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1093\/cid\/ciae291","article-title":"SARS-CoV-2 vaccination in the first year after hematopoietic cell transplant or chimeric antigen receptor T-cell therapy: a prospective, multicenter, observational study","volume":"79","author":"Hill","year":"2024","journal-title":"Clin Infect Dis"},{"key":"ref157","doi-asserted-by":"publisher","first-page":"e003428","DOI":"10.1136\/jitc-2021-003428","article-title":"Humoral immunogenicity of the seasonal influenza vaccine before and after CAR-T-cell therapy: a prospective observational study","volume":"9","author":"Walti","year":"2021","journal-title":"J Immunother Cancer"},{"key":"ref158","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1182\/blood-2020-143342","article-title":"High rates of varicella zoster virus antibody seroconversion and persistence after administration of the adjuvanted, recombinant varicella zoster vaccine in multiple myeloma patients undergoing active treatment","volume":"136","author":"Sweiss","year":"2020","journal-title":"Blood"},{"key":"ref159","doi-asserted-by":"publisher","first-page":"179","DOI":"10.3324\/haematol.2024.285161","article-title":"Respiratory syncytial virus and other vaccine-preventable infections in multiple myeloma. A population-based study on 8,672 myeloma patients diagnosed 2008-2021 from the Swedish myeloma registry","volume":"110","author":"Einarsdottir","year":"2025","journal-title":"Haematologica"},{"key":"ref160","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1007\/s15010-024-02449-w","article-title":"Respiratory syncytial virus infection in patients with haematological diseases: a retrospective multicentre study","volume":"53","author":"Herrmann","year":"2025","journal-title":"Infection"},{"key":"ref161","doi-asserted-by":"publisher","first-page":"2451456","DOI":"10.1080\/25310429.2025.2451456","article-title":"Respiratory syncytial virus vaccination in older adults and patients with chronic disorders: a position paper from the Portuguese Society of Pulmonology, the Portuguese Association of General and Family Medicine, the Portuguese Society of Cardiology, the Portuguese Society of Infectious Diseases and Clinical Microbiology, the Portuguese Society of Endocrinology, diabetes and metabolism, and the Portuguese Society of Internal Medicine","volume":"31","author":"Alfaro","year":"2025","journal-title":"Pulmonology"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1847793\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T11:12:45Z","timestamp":1782817965000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1847793\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":161,"alternative-id":["10.3389\/fmed.2026.1847793"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1847793","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]},"article-number":"1847793"}}