Clin Lymphoma Myeloma Leuk. 2026 Mar 6:S2152-2650(26)00066-2. doi: 10.1016/j.clml.2026.03.002. Online ahead of print.
ABSTRACT
BACKGROUND: Patients with multiple myeloma (MM) often have an increased risk of infection. Prophylactic immunoglobulin (Ig) supplementation has been considered a potential strategy to reduce the risk of infections, but its real-world benefit remains unclear. A prior systematic review and meta-analysis (SRMA) demonstrated a significant reduction in infection risk with Ig supplementation, but the findings may not reflect outcomes in the context of contemporary MM therapies.
PATIENTS AND METHODS: We performed an updated SRMA including observational and randomized controlled trials comparing the outcomes in patients with MM who received prophylactic Ig versus those who did not. We systematically searched PubMed, Scopus, and Cochrane Central Register of Controlled Trials from inception to July 2025.
RESULTS: A total of 10 studies were included in the systematic review. Of these, 7 studies comprising 2345 patients reported outcomes using comparable units and were included in the meta-analysis. Ig supplementation was associated with significantly lower cumulative incidence of severe infections (34.4% vs. 56.3%; P = .027). There was no difference in cumulative incidence of overall infections (50.0% vs. 38.6%; P = .70). Subgroup analysis for overall infections stratified by treatment type did not show significant differences. No differences were observed for overall survival (OS) (hazard ratio 0.57; P = .086).
CONCLUSIONS: Prophylactic Ig supplementation significantly reduced the cumulative incidence of severe infections in patients with MM. Future prospective studies are warranted to verify the findings.
PMID:41916811 | DOI:10.1016/j.clml.2026.03.002