Kidney Week

Abstract: SA-PO1244

AKI After Bispecific T-Cell Engager Therapy in Patients with Hematologic Malignancies: A Multicenter Cohort Study

Session Information

• Onconephrology: Epidemiological Trends, Risk Stratification, and Clinical Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Onconephrology

• 1600 Onconephrology

Authors

• Saldanha Neves Horta Lima, Carolina, Mass General Brigham Inc, Boston, Massachusetts, United States

Carolina Saldanha Neves Horta Lima, MD

• Anumolu, Rajesh, Mass General Brigham Inc, Boston, Massachusetts, United States

Rajesh Anumolu, MBBS

• Adomi, Motohiko, Harvard T H Chan School of Public Health, Boston, Massachusetts, United States

Motohiko Adomi, MD, MS

• Rubman, Mia B., Mass General Brigham Inc, Boston, Massachusetts, United States

Mia B. Rubman

• Litvin, Rafaella, Cleveland Clinic, Cleveland, Ohio, United States

Rafaella Litvin, MD

• Kim, Junglee, Cleveland Clinic, Cleveland, Ohio, United States

Junglee Kim, MD

• Caimi, Paolo, Cleveland Clinic, Cleveland, Ohio, United States

Paolo Caimi, MD, MBA

• Chewcharat, Api, Mass General Brigham Inc, Boston, Massachusetts, United States

Api Chewcharat, MD, MPH, FASN

• Jalal, Abdullah, Mass General Brigham Inc, Boston, Massachusetts, United States

Abdullah Jalal, MD

• Sadurski, Filip, Mass General Brigham Salem Hospital, Salem, Massachusetts, United States

Filip Sadurski, MD

• Chowdhury, Raad Bin Zakir, Mass General Brigham Inc, Boston, Massachusetts, United States

Raad Bin Zakir Chowdhury, MD, FASN

• Gupta, Shruti, Mass General Brigham Inc, Boston, Massachusetts, United States

Shruti Gupta, MD, MPH

Background

Bispecific antibodies (BsAbs) have transformed the therapeutic landscape for multiple myeloma (MM) and non-Hodgkin’s Lymphomas (NHL), offering highly effective options for relapsed and refractory disease. Despite the expanding use of BsAbs, their renal safety profile remains poorly characterized.

Methods

We retrospectively reviewed MM and NHL patients treated with BsAbs across two major academic cancer centers between December 2022 and January 2026. We assessed incidence of a composite outcome of AKI (defined as rise in serum creatinine ≥1.5-fold from pre-BsAb baseline and/or need for renal replacement therapy) or death in the 30 days following initial dose, compared to a control cohort treated with CAR-T. We used multivariable logistic regression to examine risk factors for AKI. We also examined the incidence and severity of cytokine release syndrome (CRS) in the 30 days following treatment initiation.

Results

Of 476 eligible patients who received BsAb, 91 (18.9%) developed the composite outcome of AKI (n=60), death (n=41) or both (n=11). In the CAR-T cohort, of 213 eligible patients, 50 (23.5%) had the composite outcome of AKI (n=48), death(n=4) or both (n=2). AKI severity in each group is shown in Figure 1A. In multivariable analyses, serum albumin <3 g/dL (OR 2.94, 95% CI, 1.35-6.41), platelets <150 K/uL (OR 2.15, 95% CI, 1.15-4), and serum free light chains ≥1000 mg/L (OR 2.99, 95% CI, 1.54-5.83), each assessed at the time of the first dose of BsAbs, were associated with an increased odds of AKI or death (Figure 1B). CRS grade ≥ 2 occurred in 67 (14.9%) patients treated with BsAbs compared to 65 (30.5%) receiving CAR-T (Figure 1C). Patients with AKI after bispecific therapy were more likely to have concurrent CRS grade 2 or higher than those without AKI (35 vs. 11%).

Conclusion

We identified key risk factors for AKI in patients treated with BsAbs, and also found that the incidence of AKI or death was lower in this cohort compared to CAR-T -treated patients. Patients with AKI were also more likely to have concurrent CRS.

Figure 1