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Infections after bispecific antibodies in B-cell lymphomas
Dong Hyun Kim1,2, Naryllae Lee3, Youngil Koh1,4
1Department of Internal Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea.
Blood Advances
|January 15, 2026
Summary
Bispecific antibodies (BsAbs) for B-cell lymphomas cause significant infections, with viral infections like CMV being common. Neutropenia and hypogammaglobulinemia increase infection risk, necessitating tailored supportive care.
Area of Science:
- Oncology
- Immunology
- Infectious Diseases
Background:
- Bispecific antibodies (BsAbs) offer new treatments for B-cell lymphomas.
- Infections are a known complication, but their spectrum and risk factors require further characterization.
Purpose of the Study:
- To assess the incidence, characteristics, and risk factors of infections in patients with B-cell lymphomas treated with CD3×CD20 BsAbs.
- To provide a temporal analysis of infection onset and types.
Main Methods:
- Retrospective cohort study of 122 patients treated with CD3×CD20 BsAbs from 2016-2024.
- Analysis of infectious episodes, time to onset, causative agents, and risk factors including neutropenia and hypogammaglobulinemia.
Main Results:
- 143 infectious episodes occurred in 74 patients (60.7%), with 61.5% being grade ≥3.
- Viral infections were most common (62.1%), particularly SARS-CoV-2 and cytomegalovirus (CMV).
- Neutropenia and hypogammaglobulinemia were independent risk factors for infection; hypogammaglobulinemia predicted severe infections.
Conclusions:
- Infections are frequent and can be severe in B-cell lymphoma patients receiving BsAbs.
- CMV reactivation is an underrecognized complication.
- Risk-adapted strategies and enhanced supportive care are crucial for managing infections in this population.
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