Real-world infectious complications of CD3/CD20 bispecific antibodies in relapsed/refractory non-Hodgkin lymphoma

Infections occur in up to 44% of trial participants treated with CD3/CD20 bispecific antibodies (BsAb), but real-world data are limited. In this study of 48 real-world R/R-NHL patients receiving commercial BsAbs, 50% and 23% experienced any-grade and grade ≥3 infections, respectively. The cumulative number of infections per patient at 12 months was 1.3 (95% CI: 0.81-2.1). Severe infections were mostly bacterial. Only 1 grade 5 event occurred, and no COVID-19-related deaths were observed. Severe neutropenia, lymphopenia, and hypogammaglobulinemia occurred in 39.6, 83.3, and 64.1% of patients, respectively. In exploratory univariate analyses, recent infection, aggressive histology, number of prior lines of therapy, CAR T exposure, and severe treatment-emergent lymphopenia and hypogammaglobulinemia were linked to increased infection risk. Moreover, infection was associated with decreased overall survival (HR 3.4, p = 0.0066) in the Cox proportional hazards model. These real-world findings reinforce the need for monitoring of infectious complications following BsAb therapy.