BRIEF RESEARCH REPORT article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
This article is part of the Research TopicImmunity and Immunotherapy in Multiple MyelomaView all 3 articles
Flat Dose Intravenous Immunoglobulin Primary Infection Prophylaxis in Multiple Myeloma Patients on BCMA and GPRC5D Bispecific Antibody Therapy: The Vanderbilt Experience
Provisionally accepted
Naimisha Marneni
Spencer Lessans*
Bhagirathbhai DholariaSalyka SengsayadethEden A BiltiboVivek PatelShakthi BhaskarReena JayaniJill GilbertJordan BerlinSanjay MohanAshwin Kishtagari
David Morgan
Olalekan O Oluwole
Bipin N SavaniAdetola A Kassim
Muhamed Baljevic*- Vanderbilt University Medical Center, Nashville, United States
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Bispecific antibodies (BsAbs) can cause profound hypogammaglobulinemia. Conventional infection prophylaxis has utilized weight-based IVIG dosing. However, the use of flat IVIG dosing can significantly reduce IVIG utilization. We evaluated hypogammaglobulinemia and infection risk in relapsed/refractory multiple myeloma (RRMM) patients treated with BsAbs who received flat-dose IVIG for primary infection prophylaxis. Among thirty patients, 73% had ≥1 and 43% had ≥2 infectious episodes. By severity, 27% of infections were CTCAE v5 grade three or higher and there were 2 sepsis-related deaths. Overall, flat-dose IVIG demonstrates feasibility for primary infection prophylaxis in RRMM patients receiving BsAbs.
Keywords: bispecific antibodies (BsAbs), cellular therapies, hypogammaglobinemia, IVIG (Intravenous Immunoglobulin) administration, Multiple Myeloma
Received: 09 Oct 2025; Accepted: 23 Jan 2026.
Copyright: © 2026 Marneni, Lessans, Dholaria, Sengsayadeth, Biltibo, Patel, Bhaskar, Jayani, Gilbert, Berlin, Mohan, Kishtagari, Morgan, Oluwole, Savani, Kassim and Baljevic. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Spencer Lessans
Muhamed Baljevic
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