Teclistamab and other BCMA-targeting bispecific antibodies effectively treat advanced multiple myeloma, but significantly suppress humoral immunity, leading to high infection rates. This study highlights teclistamab’s detrimental effects on B cell counts and polyclonal immunoglobulin levels, which do not recover during treatment. It also underlines its impact on weakening vaccine responses to pathogens like Streptococcus pneumoniae, Haemophilus influenzae, and SARS-CoV-2.

To address the increased risk of infections associated with teclistamab, researchers have investigated using intravenous immunoglobulin (IVIG) as a protective measure. The findings demonstrate that IVIG effectively lowers the incidence of severe infections, particularly when used as primary prophylaxis compared to merely observational approaches. This emphasizes the importance of integrating preventive strategies like IVIG supplementation and continuous infection monitoring with teclistamab treatment to manage and mitigate infection risks.

Reference: Frerichs KA, Verkleij CPM, Mateos MV, et al. Teclistamab impairs humoral immunity in patients with heavily pretreated myeloma: importance of immunoglobulin supplementation. Blood Adv. 2024 Jan 9;8(1):194-206. doi: 10.1182/bloodadvances.2023011658. PMID: 38052042; PMCID: PMC10787247.