Evidence mapPaperPMID 42454131Full record

ReviewFrontiers in medicine2026

Practical recommendations for infectious prophylaxis and vaccination in multiple myeloma patients.

Rui Bergantim, Adriana Roque, Ana Jorge, José Guilherme Freitas, Mariana Trigo Miranda, Marta Nunes, Alina Ionita, Paulo Varanda Bernardo, Joana Vieira, Eliana Vale Aguiar and 5 more

Abstract readReview
In one paragraph

Review in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Rui BergantimClinical Hematology Department, Unidade Local de Saúde São João, Porto, Portugal.
Adriana RoqueClinical Hematology Department, Unidade Local de Saúde de Coimbra, Coimbra, Portugal.
Ana JorgeClinical Hematology Department, Unidade Local de Saúde Lisboa Ocidental, Lisbon, Portugal.
José Guilherme FreitasClinical Hematology Department, Unidade Local de Saúde de Braga, Braga, Portugal.
Mariana Trigo MirandaClinical Hematology Department, Hospital De São Teotónio, Unidade Local de Saúde Viseu Dão-Lafões, Viseu, Portugal.
Marta NunesClinical Hematology Department, Unidade Local de Saúde Gaia e Espinho, Vila Nova de Gaia, Portugal.
Alina IonitaHematology Department, Instituto Português de Oncologia Francisco Gentil de Lisboa, Lisbon, Portugal.
Paulo Varanda BernardoHematology Department, Instituto Português de Oncologia Francisco Gentil de Lisboa, Lisbon, Portugal.
Joana VieiraHematology and Bone Marrow Transplantation Department, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal.
Eliana Vale AguiarClinical Hematology Department, Unidade Local de Saúde São João, Porto, Portugal.
Patrícia FerrazHematology Department, Unidade Local de Saúde de Trás-Os-Montes e Alto Douro, Vila Real, Portugal.
André Silva-PintoInfectious Diseases Department, Unidade Local de Saúde São João, Porto, Portugal.
Ana Bela Sarmento-RibeiroClinical Hematology Department, Unidade Local de Saúde de Coimbra, Coimbra, Portugal.
Catarina GeraldesClinical Hematology Department, Unidade Local de Saúde de Coimbra, Coimbra, Portugal.
Cristina JoãoHemato-Oncology Unit, Fundação Champalimaud, Lisbon, Portugal.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Infections remain a major cause of morbidity and mortality in multiple myeloma (MM), driven by the interplay between disease-induced immune dysfunction and treatment-related immunosuppression. The introduction of proteasome inhibitors, immunomodulatory drugs, monoclonal antibodies, bispecific antibodies, and chimeric antigen receptor T (CAR-T) cell therapy has markedly improved survival while simultaneously reshaping the infectious risk landscape. Different treatment strategies compromise immunity in distinct mechanisms. Conventional chemotherapy and some targeted agents primarily increase the risk of bacterial infections through neutropenia. Modern immunotherapies, however, produce profound and prolonged hypogammaglobulinemia alongside cellular immune deficits, predisposing patients to viral reactivation and opportunistic infections. BCMA-targeting therapies (particularly bispecific antibodies and CAR-T cells) cause sustained plasma cell depletion and durable humoral immune impairment, resulting in an infection pattern that can persist well beyond treatment completion. Effective prevention requires a risk-stratified approach accounting for disease stage, treatment regimen, cumulative immunosuppression, and individual patient characteristics. This review synthesizes current evidence and provides practical, treatment-specific recommendations spanning infection risk assessment, pre-treatment screening, antimicrobial and antifungal prophylaxis, antiviral strategies, immunoglobulin replacement, granulocyte colony-stimulating factor use, and vaccination. Emphasis is placed on bispecific antibodies and CAR-T cell therapies, where infectious risk is greatest and prophylactic strategies are evolving most rapidly. Immunoglobulin replacement is highlighted as an increasingly relevant supportive strategy, with recent observational studies linking its use to marked reductions in serious infections and, among recipients of anti-BCMA bispecific antibodies, improved survival. This review provides clinicians with a practical framework for individualized infection prevention in the evolving therapeutic landscape of MM.

Indexed as

CAR-T cell therapyimmunoglobulin replacementmultiple myelomaprophylaxissecondary immunodeficiency

Identifiers

PMID42454131
PMCPMC13366191

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.