Immune biomarkers of increased infection risk in multiple myeloma
Year: 2026
Type: article
Study design: Observational Study
Abstract: ABSTRACT: Infection remains a leading cause of morbidity in multiple myeloma. Preventing infections is paramount and immune profiling could reflect the cumulative effect of host-, tumor-, and treatment-related immunosuppression. However, current understanding of immune dysfunction and its association with infection is limited. To address this gap in knowledge and identify immune biomarkers of increased infection risk, we performed immune profiling using next-generation flow cytometry in bone marrow and peripheral blood samples from 1786 patients at various disease stages and treatment scenarios. Patients developing infection had significantly lower percentages of CD27+ B cells and CD27- natural killer cells, as well as an increased CD27-/CD27+ T-cell ratio in the bone marrow. These immune risk factors were validated in 3 independent data sets. An immune score was developed to stratify patients with ≤1 vs ≥2 of the aforementioned risk factors, which was associated with higher infection incidence (35% vs 60%, P< .001). The immune score (odds ratio, 2.31; P< .001), disease stage, and CD38-, B-cell maturation antigen-, or G protein-coupled receptor class C group 5 member D-targeted therapy were independently associated with infection incidence. All cell types detectable in the bone marrow and peripheral blood were significantly correlated, suggesting that immune biomarkers of increased infection risk could be monitored using minimally invasive methods that are available in routine laboratories.
Source: Blood
Authors: Aintzane Zabaleta, Luis-Esteban Tamariz-Amador, Ioannis V. Kostopoulos, Romanos Sklavenitis-Pistofidis, Febe Smits, Paula Rodriguez-Otero, Carmen Roncal, Michelle P. Aranha, David Zihala, Michaela Machu, Nikolaos Tsakirakis, Panagiotis Bakouros, Ourania Tsitsilonis, Irene Solia, Cristina Moreno, Catarina Maia, Esperanza Martin-Sanchez, José J. Perez, Cristina Encinas, Rafael Rios-Tamayo, Albert Oriol, María-Jesús Blanchard, Felipe de Arriba, María-Esther Gonzalez, Sunil Lakhwani, Anna Sureda, Valentin Cabañas, Fernando Escalante, Estrella Carrillo-Cruz, Albert Pérez-Montaña, Enrique M. Ocio, Joan Bargay, Alberto Orfao, Tomas Jelinek, Irene M. Ghobrial, Tuna Mutis, Sonja Zweegman, Evangelos Terpos, Efstathios Kastritis, Joaquin Martinez-Lopez, Juan-José Lahuerta, Carlos Fernandez de Larrea, Laura Rosiñol, Joan Bladé, Maria-Victoria Mateos, Jesús San-Miguel, Maria-Teresa Cedena, Noemi Puig, Bruno Paiva
Institutions: Navarre Institute of Health Research, Clinica Universidad de Navarra, Centro de Investigación Médica Aplicada, National and Kapodistrian University of Athens, Broad Institute, Harvard University, Dana-Farber Cancer Institute, Massachusetts Institute of Technology, Haga Hospital, Amsterdam University Medical Centers, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, University of Ostrava, University Hospital Ostrava, Masaryk University, University Hospital Brno, Instituto de Investigación Biomédica de Salamanca, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Biosanitaria de Granada, Hospital Universitario Virgen de las Nieves, Josep Carreras Leukaemia Research Institute, Institut Català d'Oncologia, Hospital Universitario Ramón y Cajal, Hospital General Universitario Morales Meseguer, Instituto Murciano de Investigación Biosanitaria, Universidad de Murcia, Hospital Universitario De Cabueñes, Universidad de La Laguna, Hospital Universitario de Canarias, Hospital Universitario Virgen de la Arrixaca, Hospital Universitario de León, Consejo Superior de Investigaciones Científicas, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Hospital Universitario Son Espases, Universidad de Cantabria, Marqués de Valdecilla University Hospital, Instituto de Investigación Marqués de Valdecilla, Hospital Son Llatzer, Health Research Institute of the Balearic Islands, Universidad de Salamanca, Centro de Investigación del Cáncer, Hospital Universitario 12 De Octubre, Centro de Investigación Biomédica en Red, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7126031531