From the Guidelines
Current diagnostic, monitoring, prophylaxis, and therapeutic strategies for patients with multiple myeloma receiving bispecific antibody therapy prioritize a personalized and proactive approach to prevent and manage infections, as recommended by the most recent expert panel consensus published in the Blood Cancer Journal in 2023 1.
Key Findings
- For HBV, screening for core antibodies and surface antigens prior to prophylaxis, and maintaining dosing during prophylaxis, with pre-emptive anti-viral treatment for those with positive DNA tests/viremia, is recommended 1.
- Influenza vaccination and oseltamivir or baloxivir treatment, as per standard guidelines, are advised for patients receiving bispecific antibodies 1.
- For SARS-COV-2, following center protocols for monitoring, PCR testing for diagnosis, and treatment with available therapies based on symptoms and physician assessment, considering concurrent medications, are recommended 1.
- Bacterial infection prophylaxis is recommended in patients with prolonged neutropenia, high risk of infections, or history of recurrent bacterial infections, with treatment dependent on the infectious agent and maintaining dosing during prophylaxis 1.
- Fungal infection prophylaxis with fluconazole, itraconazole, or voriconazole, and treatment as per infectious disease guidelines, are suggested 1.
Therapeutic Strategies
- Temporary discontinuation of bispecific antibody therapy is recommended in patients with COVID-19 until clinical resolution, together with RT-PCR clearance testing 1.
- Antithrombotic therapy in arterial thrombosis and thromboembolism in COVID-19 patients should be managed according to the American College of Chest Physicians expert panel report, which supports therapeutic-dose anticoagulation in acutely ill patients and prophylactic-dose LMWH in critically ill patients 1.
Prophylaxis and Monitoring
- Vaccination programs, preventive medications, and lifestyle interventions are effective strategies for disease prevention 1.
- Monitoring capabilities, including wearable devices and remote patient monitoring systems, provide continuous data collection for better disease management 1.
Personalized Medicine
- Targeted therapies, immunotherapies, and personalized medicine approaches tailor treatments to individual genetic profiles, enabling more precise, timely, and effective interventions across various medical conditions 1.
From the Research
Diagnostics, Monitoring, Prophylaxis, and Therapeutic Strategies
- The current findings on diagnostics, monitoring, prophylaxis, and therapeutic strategies for COVID-19 are based on various studies, including 2, 3, 4, 5, 6.
- Diagnostics and Monitoring: There is no specific information on diagnostics and monitoring in the provided studies, however, they focus on the treatment and prevention of COVID-19.
- Prophylaxis: Vaccination of the population is essential to control the pandemic, with licensed vaccines including mRNA vaccines (Tozinameran and mRNA-1273) and vector vaccines (AZD1222) showing high efficacy in large clinical trials 2, 5, 6.
- Therapeutic Strategies:
- Antiviral Treatment: Remdesivir is considered a promising agent, while favipiravir, molnupiravir, paxlovid, and lopinavir/ritonavir have shown improved therapeutic effects in terms of virus elimination 3.
- Anti-inflammatory Treatment: Corticosteroids, such as dexamethasone, should be administered later in the course of the disease in patients receiving oxygen therapy 2.
- Convalescent Plasma: The application of convalescent plasma from patients who recovered from a SARS-CoV-2 infection is reasonable, but large-scale studies indicated low efficacy 2, 4.
- Monoclonal Antibodies: Tocilizumab is used for the treatment of patients with COVID-19-related pneumonia, and other monoclonal antibodies are being investigated for their potential in treating COVID-19 3, 4.
- Supportive Treatment: Supportive treatment for patients with COVID-19 may involve the use of vitamins, natural substances, and other therapies 3.