Topics:
Hematologic Malignancies • Medical Oncology • Myeloma • NCI-CCC Tumor Board Question • Mayo Clinic • NCI-CCC Myeloma Tumor Board Question • Multiple Myeloma • Mayo
What is your approach to mitigating the infection risk with bispecific antibodies in multiple myeloma?
Answer from: Medical Oncologist at Academic Institution
As of June 2023, anybody who says they have a definite answer to this is misleading you. We are unfortunately learning as we go, and LOTS of loose ends to be tied up. I'd argue everybody in this setting should already be on universal VZV prophylaxis (e.g., acyclovir), and I'd also argue that most of...
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Answer from: Medical Oncologist at Academic Institution
VZV/PJP prophylaxis
IVIg q 4 weeks for hypogammaglobulinemia
PEG-GCSF support for neutropenia
If the patient has response plateau for 2 consecutive cycles, then move to q 2-week dosing or even q 4-week dosing sooner than later. I am doing this in clinical practice as early as cycle 3 or 4. Chec...
Answer from: Medical Oncologist at Academic Institution
I agree with Dr. @Banerjee. PCP prophylaxis may need to be considered.
Answer from: at Academic Institution
I agree with Dr. @Banerjee. VZV, PJP prophylaxis and consider levofloxacin for a short period (usually first month). Quantitative immunoglobulins should be closely followed. Monitoring serum CMV PCR may lead to over-treatment if the patient just has CMV viremia and not an actual CMV infection, but w...