Immune biomarkers of increased infection risk in multiple myeloma

• Authors: ZABALETA Aintzane; TAMARIZ-AMADOR Luis-Esteban; IOANNIS V Kostopoulos; SKLAVENITIS-PISTOFIDIS Romanos; SMITS Febe; RODRIGUEZ-OTERO Paula; RONCAL Carmen; ARANHA Michelle P; ZIHALA David; MACHŮ Michaela; TSAKIRAKIS Nikolaos; BAKOUROS Panagiotis; TSITSILONIS Ourania; SOLIA Irene; MORENO Cristina; MAIA Catarina; MARTIN-SANCHEZ Esperanza; PEREZ Jose J; ENCINAS Cristina; RIOS-TAMAYO Rafael; ORIOL Albert; BLANCHARD Maria-Jesus; FELIPE de Arriba; GONZALEZ Maria-Esther; LAKHWANI Sunil; SUREDA Anna; CABAN Valentin; ESCALANTE Fernando; CARRILLO-CRUZ Estrella; PEREZ-MONTAN Albert; OCIO Enrique M; BARGAY Joan; ORFAO Alberto; JELINEK Tomas; GHOBRIAL Irene M; MUTIS Tuna; ZWEEGMAN Sonja; TERPOS Evangelos; KASTRITIS Efstathios; MARTINEZ-LOPEZ Joaquin; LAHUERTA Juan-Jose; FERNANDEZ de Larrea Carlos; ROSIN Laura; BLADE Joan; MATEOS Maria-Victoria; SAN-MIGUEL Jesus; CEDENA Maria-Teresa; PUIG Noemi; PAIVA Bruno
• Year of publication: 2026
• Type: Peer-reviewed scientific article
• Magazine / Source: Blood
• MU Faculty or unit: Faculty of Medicine
• web: https://ashpublications.org/blood/article-abstract/147/18/2081/566336/Immune-biomarkers-of-increased-infection-risk-in?redirectedFrom=fulltext
• Doi: https://doi.org/10.1182/blood.2025031744
• Keywords: multiple myeloma; infection risk; immune biomarkers; immune dysfunction; prognostic markers
• Description: 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.