What are the infection rates for patients with relapsed/refractory multiple myeloma taking teclistamab?
Teclistamab is a bispecific antibody used to treat relapsed/refractory multiple myeloma. It works by redirecting immune cells to attack myeloma cells, but it also lowers antibody levels (hypogammaglobulinemia), which raises infection risk. A 2024 meta-analysis pooled data from clinical trials and real-world studies to give a clearer picture of infection rates.
What the research says
A meta-analysis of 5 studies including 714 patients found that the overall rate of any infection was 56.5%, and the rate of severe (grade ≥3) infections was 27.6% 5. Infections were more common in the clinical trial setting (76.4% any-grade, 44.8% grade ≥3) compared to real-world evidence (45.4% any-grade, 22.8% grade ≥3) 5. The difference may be due to stricter monitoring in trials. Another study on BCMA-targeted bispecific antibodies (similar to teclistamab) reported that 41% of patients had a grade 3-5 infection, with most infections occurring during disease remission 11. That study also found that intravenous immunoglobulin (IVIg) use was linked to a 90% lower rate of serious infections 11. A qualitative review noted that infections are a key safety concern with bispecific antibodies, and that supportive care, including infection monitoring, is important 8.
What to ask your doctor
- What is my personal risk of infection while on teclistamab, given my health history?
- Should I receive intravenous immunoglobulin (IVIg) to help prevent serious infections?
- What vaccines are recommended before starting teclistamab, and when should I get them?
- What signs of infection should I watch for, and when should I contact you?
- Are there any prophylactic antibiotics or antivirals I should take during treatment?
This question is drawn from common patient questions about Hematology and answered using cited medical research. We do not provide individualized advice.