Abstract: SA-PO1254
AKI After Bispecific Antibody Therapy in Patients with Plasma Cell and Lymphoid Malignancies
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
- Abu Amer, Nabil, Sheba Medical Center, Tel HaShomer, Tel Aviv District, Israel
- Givon, Amir, Sheba Medical Center, Tel HaShomer, Tel Aviv District, Israel
- Erman, Orit, Sheba Medical Center, Tel HaShomer, Tel Aviv District, Israel
- Kunin, Margarita, Sheba Medical Center, Tel HaShomer, Tel Aviv District, Israel
- Beckerman, Pazit, Sheba Medical Center, Tel HaShomer, Tel Aviv District, Israel
Background
Bispecific antibodies are increasingly used for relapsed/refractory plasma cell and lymphoid malignancies, but data on kidney safety and the relationship between acute kidney injury (AKI) and cytokine release syndrome (CRS) remain limited.
Methods
A retrospective study of patients with lymphoma, chronic lymphocytic leukemia, or multiple myeloma treated with bispecific antibodies at a referral medical center. Baseline creatinine was the most recent pretreatment value. AKI was classified using KDIGO thresholds: stage 1, ≥0.3 mg/dL increase or 1.5–1.9 times baseline; stage 2, 2.0–2.9 times; and stage 3, ≥3 times or peak creatinine ≥4.0 mg/dL. CRS was assessed using structured diagnosis, free-text documentation, and tocilizumab use as a marker of CRS.
Results
Among 236 evaluable patients, the mean age was 63.5±13.7 years, and 145 (61.4%) were male. Diagnoses included lymphoma in 117 (49.6%), multiple myeloma in 110 (46.6%), and CLL in 9 (3.8%). The median baseline creatinine was 0.90 mg/dL (IQR 0.72–1.11), and the median peak post-treatment creatinine was 1.18 mg/dL (IQR 0.92–1.58). AKI occurred in 106 patients (44.9%): stage 1 in 72 (30.5%), stage 2 in 13 (5.5%), and stage 3 in 21 (8.9%). AKI rates were 45.3% in lymphoma, 40.9% in multiple myeloma, and 88.9% in CLL. Patients with AKI had higher baseline creatinine than those without AKI [0.93 (0.73–1.27) vs. 0.87 (0.71–1.03) mg/dL; p=0.041] and a higher prevalence of hypertension (43.4% vs. 27.7%; p=0.014).
CRS-related evidence was present in 133 patients (56.4%), and AKI occurred in 61/133 patients with CRS-related evidence versus 45/103 without CRS-related evidence (45.9% vs. 43.7%; p=0.739). Among patients with CRS-related evidence, AKI stage 1 occurred in 42 patients (31.6%), stage 2 in 4 (3.0%), and stage 3 in 15 (11.3%). Among patients without CRS-related evidence, AKI stage 1 occurred in 30 patients (29.1%), stage 2 in 9 (8.7%), and stage 3 in 6 (5.8%). Overall, AKI stage distribution did not differ significantly by CRS-related evidence (p=0.135).
Conclusion
In this real-world patient group on bispecific antibodies, AKI was common, mostly stage 1. Higher baseline creatinine and hypertension increased AKI risk. CRS was frequent but not linked to higher AKI rates or stages. More studies with detailed CRS grading, clinical data, and kidney recovery info are needed to clarify kidney risks and outcomes after bispecific therapy.
Acknowledgment
None