Dr Shah on the Effect of IVIG on Infection Risk in R/R Multiple Myeloma

“When we looked overall, the risk of developing infections was significantly lower in the IVIG group with primary prophylaxis, particularly bacterial infections, but it didn't really have as much of an impact on viral infections.”

Mansi R. Shah, MD, assistant professor, medicine, Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson (RWJ) Medical School; hematologist/oncologist, RWJ University Hospital, highlights the data on the effects of intravenous immunoglobulin (IVIG) supplementation on infections in patients with relapsed/refractory multiple myeloma treated with teclistamab-cqyv (Tecvayli). These data were presented at the 2024 ASH Annual Meeting.

The study included patients with relapsed/refractory multiple myeloma (n = 168) who received primary prophylaxis and secondary prophylaxis, Shah explains. The risk of bacterial infections was shown to be significantly lower in patients treated with primary prophylaxis, she notes.

Of note, the most common dosing schedule for IVIG was 0.4 mg/kg every 4 weeks. There were 181 recorded infections among 92 patients. Infections included 53% that were bacterial in 61 patients, 42% were viral in 52 patients, and 9 fungal infections were observed in 7 patients. Of these infections, 55% were grade 3 or greater, with 57% of these infections requiring inpatient hospitalization. The 3-month cumulative incidence of all-grade infection was 43% (95% CI, 36%-52%), and the rate of grade 3 or greater infection was 23% (95% CI, 15%-92%). Regarding those who were not given IVIG, the 3-month cumulative incidence of all-grade infection was 49% (95% CI, 39%-61%). In patients on primary and secondary IVIG, the 3-month cumulative incidence of all-grade infection was 36% (95% CI, 26%-50%) and 38% (95% CI, 15%-92%).

In patients treated with secondary prophylaxis who received IVIG after developing an infection, the IVIG did not make a significant impact on viral infections, she says. In patients from the secondary group, she concludes that IVIG had an impact on bacterial infections but not other infections.