ArticleEJHaem2026
European Recommendations for Transitioning the Care of Patients With Multiple Myeloma Treated With B-Cell Maturation Antigen Bispecific Antibodies From Academic Hospitals to Community-Based Centers and for Outpatient Step-Up Dosing.
Article in EJHaem, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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11 authors.
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Abstract
Introduction: Safe outpatient delivery of B-cell maturation antigen-targeting bispecific antibodies (BCMA-BsAbs) in multiple myeloma (MM) is challenging, particularly during step-up dosing (SUD). Standardized guidance for European community practice is limited. Methods: A modified Delphi methodology panel sought expert consensus on safe, effective outpatient SUD and transition of care from academic to community centers for patients receiving BCMA-BsAbs. A steering committee of 10 European specialists in MM and BCMA-BsAb delivery generated statements based on literature review and clinical experience. Statements were tested in three rounds with a Delphi panel of 53 clinicians (hematologists, nurses, pharmacists) across France, Germany, Italy, Portugal, Spain, and the United Kingdom. Consensus was defined as ≥ 75% agreement. Results: Consensus was achieved for 84 statements. Key recommendations included: (1) patient stability before community center transition (afebrile ≥ 24 h, ASTCT Grade 0 toxicity, stable organ function); (2) community center requirements (training in cytokine release syndrome/immune effector cell-associated neurotoxicity syndrome, urgent laboratory access, tocilizumab and corticosteroids on-site, 24/7 escalation protocols); and (3) infection management (baseline cytomegalovirus testing, immunoglobulin [Ig] monitoring, prophylaxis with intravenous/subcutaneous Ig for IgG < 400 mg/dL, antiviral/ Conclusion: This European Delphi consensus provides a structured framework for outpatient SUD and transition of BCMA-BsAb therapy in MM. Adopting these recommendations may improve safety and consistency and expand accessibility. Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.
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