Clinical Scorecard: Increased Incidence of Campylobacter spp. Infections Linked to Bispecific Antibodies Targeting BCMA and GPRC5D
At a Glance
Category
Detail
Condition
Campylobacter spp. infections in patients with relapsed/refractory multiple myeloma
Key Mechanisms
Bispecific antibodies targeting BCMA and GPRC5D cause depletion of normal plasma cells leading to secondary hypogammaglobulinemia and increased infection risk
Target Population
Patients with relapsed/refractory multiple myeloma treated with bispecific antibodies against BCMA and GPRC5D
Care Setting
Hematology and oncology clinical settings managing multiple myeloma
Key Highlights
Bispecific antibodies targeting BCMA and GPRC5D show efficacy but increase risk of infections due to hypogammaglobulinemia.
In a cohort of 85 patients, 9 developed Campylobacter infections including bloodstream and gastrointestinal episodes.
Secondary hypogammaglobulinemia and immunosuppression from therapy and disease contribute to vulnerability to Campylobacter spp.
Guideline-Based Recommendations
Diagnosis
Monitor for Campylobacter spp. infections in patients receiving BCMA and GPRC5D bispecific antibodies.
Use blood cultures and stool cultures or multiplex gastrointestinal panels for detection.
Perform species identification and antimicrobial susceptibility testing following EUCAST guidelines.
Management
Manage infections promptly with appropriate antimicrobial therapy guided by susceptibility testing.
Consider intravenous immunoglobulin therapy (IVIG) to address hypogammaglobulinemia.
Monitor white blood cell counts, neutrophil and lymphocyte differentials, and serum albumin.
Surveillance for infectious complications should be intensified in the first 6 months of therapy.
Risks
Secondary hypogammaglobulinemia due to plasma cell depletion increases infection susceptibility.
Advanced age, frailty, comorbidities, and baseline immunosuppression further elevate infection risk.
Campylobacter infections can present as bloodstream or gastrointestinal disease in this population.
Patient & Prescribing Data
85 patients with relapsed/refractory multiple myeloma treated with bispecific antibodies targeting BCMA and GPRC5D
Treatment with these bispecific antibodies is associated with a notable incidence of Campylobacter infections, necessitating targeted infection prevention and monitoring strategies.
Clinical Best Practices
Implement targeted surveillance for Campylobacter spp. infections in patients receiving BCMA and GPRC5D bispecific antibodies.
Regularly assess immunoglobulin levels and consider IVIG supplementation to mitigate hypogammaglobulinemia.
Promptly investigate and treat suspected infections with culture and susceptibility-guided antimicrobials.
Recognize patient-related risk factors such as age and comorbidities to tailor preventive strategies.
by Idoia Bilbao, María Ansón, Sara Villar, Iñigo Pineda, Laura Gárriz, Manuel Pina-Sánchez, Luis-Esteban Tamariz-Amador, Paula Rodríguez-Otero, José Ramón Yuste, José L del Pozo
