Publicaciones científicas
Immune biomarkers of increased infection risk in multiple myeloma
Aintzane Zabaleta 1, Luis-Esteban Tamariz-Amador 2, Ioannis V Kostopoulos 3, Romanos Sklavenitis Pistofidis 4, Febe Smits 5, Paula Rodriguez-Otero 6, Carmen Roncal 7, Michelle P Aranha 4, David Žihala 8, Michaela Machu 9, Nikolaos Tsakirakis 3, Panagiotis Bakouros 3, Ourania Tsitsilonis 3, Irene Solia 10, Cristina Moreno 11, Catarina Maia 12, Esperanza Martin-Sanchez 11, José Juan Pérez Sr 13, Cristina Encinas 14, Rafael Ríos-Tamayo 15, Albert Oriol 16, María-Jesús Blanchard 17, Felipe de Arriba 18, Esther González-García 19, Sunil Lakhwani 20, Anna Sureda 16, Valentín Cabañas 21, Fernando Escalante 22, Estrella Carrillo-Cruz 23, Albert Pérez-Montaña 24, Enrique María M Ocio 25, Joan Bargay 26, Alberto Orfao 27, Tomas Jelínek 8, Irene M Ghobrial 4, Tuna Mutis 28, Sonja Zweegman 28, Evangelos Terpos 10, Efstathios Kastritis 10, Joaquín Martínez-López 29, Juan-Jose Lahuerta 29, Carlos Fernández de Larrea 30, Laura Rosiñol 30, Joan Bladé 30, Maria-Victoria Mateos 13, Jesús F San-Miguel 31, Maria Teresa Cedena 32, Noemi Puig 13, Bruno Paiva 11
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 1,786 patients at various disease stages and treatment scenarios. Patients developing infection had significantly lower percentages of CD27+ B cells and CD27- NK cells, as well as increased CD27-/CD27+ T-cell ratio in bone marrow. These immune risk factors were validated in three independent datasets. 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, BCMA or GPRC5D targeted therapy were independently associated with infection incidence. All cell types detectable in 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.
CITA DEL ARTÍCULO Blood. 2026 Jan 29:blood.2025031744. doi: 10.1182/blood.2025031744. Online ahead of print.
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