2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T5e5,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.31:T67b, 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. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"GPRC5D-Targeted Therapy: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on GPRC5D-Targeted Therapy (modality). Clinician-written summaries and actionable practice insights. 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de Investigacion Medica Aplicada, Instituto de Investigacion Sanitaria de Navarra, CIBER-ONC number CB16/12/00369, Pamplona, Spain"}]},{"given":"Luis-Esteban","family":"Tamariz-Amador","sequence":"additional","affiliation":[{"name":"1Cancer Center Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada, Instituto de Investigacion Sanitaria de Navarra, CIBER-ONC number CB16/12/00369, Pamplona, Spain"}]},{"given":"Ioannis V.","family":"Kostopoulos","sequence":"additional","affiliation":[{"name":"2Department of Biology, National and Kapodistrian University of Athens, Athens, Greece"}]},{"given":"Romanos","family":"Sklavenitis-Pistofidis","sequence":"additional","affiliation":[{"name":"3Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA"},{"name":"4Harvard Medical School, Boston, MA"},{"name":"5Cancer Program, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA"}]},{"given":"Febe","family":"Smits","sequence":"additional","affiliation":[{"name":"6Department of Hematology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"},{"name":"7Cancer Biology and Immunology, Cancer Center Amsterdam, Amsterdam, The Netherlands"},{"name":"8Department of Hematology, HagaZiekenhuis, The Hague, The Netherlands"}]},{"given":"Paula","family":"Rodriguez-Otero","sequence":"additional","affiliation":[{"name":"1Cancer Center Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada, Instituto de Investigacion Sanitaria de Navarra, CIBER-ONC number CB16/12/00369, Pamplona, Spain"}]},{"given":"Carmen","family":"Roncal","sequence":"additional","affiliation":[{"name":"1Cancer Center Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada, Instituto de Investigacion Sanitaria de Navarra, CIBER-ONC number CB16/12/00369, Pamplona, Spain"}]},{"given":"Michelle P.","family":"Aranha","sequence":"additional","affiliation":[{"name":"3Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA"},{"name":"4Harvard Medical School, Boston, MA"},{"name":"5Cancer Program, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA"}]},{"given":"David","family":"Zihala","sequence":"additional","affiliation":[{"name":"9Department of Hematooncology, University Hospital Ostrava and Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic"}]},{"given":"Michaela","family":"Machu","sequence":"additional","affiliation":[{"name":"10Faculty of Medicine, Masaryk University, Brno, Czech Republic"},{"name":"11Department of Clinical Hematology, University Hospital Brno, Brno, Czech Republic"}]},{"given":"Nikolaos","family":"Tsakirakis","sequence":"additional","affiliation":[{"name":"2Department of Biology, National and Kapodistrian University of Athens, Athens, Greece"}]},{"given":"Panagiotis","family":"Bakouros","sequence":"additional","affiliation":[{"name":"2Department of Biology, National and Kapodistrian University of Athens, Athens, Greece"}]},{"given":"Ourania","family":"Tsitsilonis","sequence":"additional","affiliation":[{"name":"2Department of Biology, National and Kapodistrian University of Athens, Athens, Greece"}]},{"given":"Irene","family":"Solia","sequence":"additional","affiliation":[{"name":"12Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece"}]},{"given":"Cristina","family":"Moreno","sequence":"additional","affiliation":[{"name":"1Cancer Center Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada, Instituto de Investigacion Sanitaria de Navarra, CIBER-ONC number CB16/12/00369, Pamplona, Spain"}]},{"given":"Catarina","family":"Maia","sequence":"additional","affiliation":[{"name":"1Cancer Center Clinica Universidad de Navarra, Centro de Investigacion Medica 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las Nieves, ibs.Granada, Granada, Spain"}]},{"given":"Albert","family":"Oriol","sequence":"additional","affiliation":[{"name":"16Department of Hematology, Institut Català d’Oncologia and Institut Josep Carreras, Barcelona, Spain"}]},{"given":"María-Jesús","family":"Blanchard","sequence":"additional","affiliation":[{"name":"17Department of Hematology, Hospital Universitario Ramon y Cajal, Madrid, Spain"}]},{"given":"Felipe","family":"de Arriba","sequence":"additional","affiliation":[{"name":"18Department of Hematology, Hospital Morales Meseguer, IMIB Pascual Parrilla, Universidad de Murcia, Murcia, Spain"}]},{"given":"María-Esther","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"19Department of Hematology, Hospital Universitario Cabueñes, Gijón, Spain"}]},{"given":"Sunil","family":"Lakhwani","sequence":"additional","affiliation":[{"name":"20Department of Hematology, Hospital Universitario de Canarias, Universidad de la Laguna, Santa Cruz de Tenerife, Spain"}]},{"given":"Anna","family":"Sureda","sequence":"additional","affiliation":[{"name":"16Department of Hematology, Institut Català d’Oncologia and Institut Josep Carreras, Barcelona, Spain"}]},{"given":"Valentin","family":"Cabañas","sequence":"additional","affiliation":[{"name":"21Department of Hematology, IMIB Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain"}]},{"given":"Fernando","family":"Escalante","sequence":"additional","affiliation":[{"name":"22Department of Hematology, Complejo Hospitalario de León, León, Spain"}]},{"given":"Estrella","family":"Carrillo-Cruz","sequence":"additional","affiliation":[{"name":"23Unidad de Gestión Clínica de Hematología, Hospital Virgen del Rocío, Instituto de Biomedicina (IBIS/CSIC/CIBERONC), Universidad de Sevilla"}]},{"given":"Albert","family":"Pérez-Montaña","sequence":"additional","affiliation":[{"name":"24Department of Hematology, Hospital Universitario Son Espases, Palma, Spain"}]},{"given":"Enrique M.","family":"Ocio","sequence":"additional","affiliation":[{"name":"25Department of Hematology, Hospital Universitario Marqués de Valdecilla (IDIVAL), Universidad de Cantabria, Santander, Spain"}]},{"given":"Joan","family":"Bargay","sequence":"additional","affiliation":[{"name":"26Department of Hematology, Hospital Universitario Son Llatzer, Institut d'Investigació Sanitària Illes Balears, Palma de Mallorca, Spain"}]},{"given":"Alberto","family":"Orfao","sequence":"additional","affiliation":[{"name":"27Department of Medicine and Cytometry Service, Centro de Investigacion del Cancer (IBMCC, USAL-CSIC), University of Salamanca, CIBER-ONC CB16/12/00400, Salamanca, Spain"}]},{"given":"Tomas","family":"Jelinek","sequence":"additional","affiliation":[{"name":"9Department of Hematooncology, University Hospital Ostrava and Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic"}]},{"given":"Irene M.","family":"Ghobrial","sequence":"additional","affiliation":[{"name":"3Department 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Greece"}]},{"given":"Efstathios","family":"Kastritis","sequence":"additional","affiliation":[{"name":"12Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece"}]},{"given":"Joaquin","family":"Martinez-Lopez","sequence":"additional","affiliation":[{"name":"28Department of Hematology, Hospital Universitario 12 de Octubre, CIBER-ONC number CB16/12/00369, Madrid, Spain"}]},{"given":"Juan-José","family":"Lahuerta","sequence":"additional","affiliation":[{"name":"28Department of Hematology, Hospital Universitario 12 de Octubre, CIBER-ONC number CB16/12/00369, Madrid, Spain"}]},{"given":"Carlos","family":"Fernandez de Larrea","sequence":"additional","affiliation":[{"name":"29Department of Hematology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain"}]},{"given":"Laura","family":"Rosiñol","sequence":"additional","affiliation":[{"name":"29Department of Hematology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, 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Spain"}]},{"given":"Noemi","family":"Puig","sequence":"additional","affiliation":[{"name":"13Department of Hematology, Hospital Universitario de Salamanca Hematología, Instituto de Investigación Biomédica de Salamanca, CIBER-ONC number CB16/12/00233, Salamanca, Spain"}]},{"given":"Bruno","family":"Paiva","sequence":"additional","affiliation":[{"name":"1Cancer Center Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada, Instituto de Investigacion Sanitaria de Navarra, CIBER-ONC number CB16/12/00369, Pamplona, 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myeloma","updated":"2026-05-12T08:54:10+00:00","published_date":"2026-01-29","best_oa_location":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13155953/","pmh_id":"oai:pubmedcentral.nih.gov:13155953","url_for_pdf":null,"url_for_landing_page":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13155953/"}}},"created_at":"2026-05-07T22:51:13.599Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.1182/blood.2025031744","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1182/blood.2025031744","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1182/blood.2025031744","tag_type":"condition","value":"Infection","value_numeric":null},{"paper_doi":"10.1182/blood.2025031744","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1182/blood.2025031744","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1182/blood.2025031744","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1182/blood.2025031744","tag_type":"modality","value":"Anti-CD38 Therapy","value_numeric":null},{"paper_doi":"10.1182/blood.2025031744","tag_type":"modality","value":"BCMA-Targeted Therapy","value_numeric":null},{"paper_doi":"10.1182/blood.2025031744","tag_type":"modality","value":"GPRC5D-Targeted Therapy","value_numeric":null},{"paper_doi":"10.1182/blood.2025031744","tag_type":"sample_size","value":"n=1786","value_numeric":1786},{"paper_doi":"10.1182/blood.2025031744","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1182/blood.2025031744","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1182/blood.2025031744","tag_type":"warning","value":"GPRC5D is referenced as a therapeutic target (GPRC5D-targeted therapy); specific agents (e.g., talquetamab) are not named in the abstract.","value_numeric":null},{"paper_doi":"10.1182/blood.2025031744","tag_type":"warning","value":"'Practice_changing' impact flag applied cautiously — the immune score requires prospective clinical validation before routine implementation is recommended.","value_numeric":null},{"paper_doi":"10.1182/blood.2025031744","tag_type":"warning","value":"Study design is described as observational/cohort; it is labeled 'prospective' but the abstract does not explicitly confirm prospective enrollment for all cohorts — clinicians should verify design details in the full text.","value_numeric":null},{"paper_doi":"10.1182/blood.2025031744","tag_type":"warning","value":"The abstract does not specify patient age range, sex distribution, or ethnic composition, limiting assessment of generalizability.","value_numeric":null}],"summaries":{"what_studied":"Immune profiling via next-generation flow cytometry was performed on bone marrow and peripheral blood samples from 1,786 multiple myeloma patients across various disease stages and treatment scenarios to identify immune biomarkers associated with increased infection risk.","key_result":"Patients who developed infections had lower bone marrow CD27+ B cells, lower CD27− NK cells, and a higher CD27−/CD27+ T-cell ratio. An immune score combining ≤1 vs ≥2 of these risk factors stratified infection incidence at 35% vs 60% (P<.001); the score was independently associated with infection (OR 2.31, P<.001), alongside disease stage and CD38-, BCMA-, or GPRC5D-targeted therapy.","limitations":"Observational design limits causal inference. Bone marrow sampling is invasive, though peripheral blood correlates were noted. The immune score was validated in 3 independent datasets but generalizability across all treatment regimens and ethnic populations is unclear.","practice_takeaway":"Consider using a simple 3-marker immune score (CD27+ B cells, CD27− NK cells, CD27−/CD27+ T-cell ratio) to flag myeloma patients at high infection risk before or during therapy. Peripheral blood appears sufficient for monitoring, making this feasible in routine labs."}}],"initialOffset":1,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"GPRC5D-Targeted Therapy"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"GPRC5D-Targeted Therapy"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"GPRC5D-Targeted Therapy"}}}]]

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