SynthesisFrontiers in oncology2026
Cytomegalovirus infection in patients receiving bispecific antibodies for multiple myeloma and B-cell malignancies: a single-center cohort and meta-analysis.
Synthesis in Frontiers in oncology, 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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Abstract
Background: Bispecific antibodies (BsAbs) are transformative therapies for multiple myeloma (MM) and B-cell malignancies. Cytomegalovirus (CMV) infection has been reported as a potential complication of unclear clinical magnitude. Methods: We conducted a retrospective study of MM patients treated with BsAbs at our institution (2020-2025), alongside a systematic review and meta-analysis of clinical trials and observational studies evaluating BsAbs for MM, B-cell lymphoma, and acute lymphoblastic leukemia. Study outcomes included clinically significant CMV infection (csCMVi), any CMV DNAemia, and CMV disease. Results: Our cohort included 98 BsAb therapy courses (74.5% anti-B-cell maturation antigen [BCMA]) with a median follow-up of 10.4 months. Cumulative incidence rates for csCMVi and CMV disease were 9.2% (9/98) and 3.1% (3/98), respectively. Factors associated with csCMVi at the univariable level were poorer functional status, prior allogeneic hematopoietic stem cell transplantation (allo-HSCT), grade 4 neutropenia, and grade ≥3 cytokine release syndrome (CRS). The meta-analysis (23 studies plus our single-center cohort comprising 2,956 BsAb courses) revealed a pooled cumulative incidence rates of 9% (95% confidence interval [CI]: 4-15%; I Conclusion: The occurrence of csCMVi or CMV disease during the course of BsAb therapy for MM or B-cell malignancies is uncommon, arguing against routine CMV DNAemia monitoring or antiviral prophylaxis. Prevention approaches, however, may be warranted in patients receiving anti-BCMA BsAbs with additional risk factors such as allo-HSCT or severe CRS. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420251162657.
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