1/ Our call to action is out in Blood Advances! Title speaks for itself. Given concerningly high infection risk with bsAbs in myeloma #MMsm, IVIG/SCIG should be started regardless of any IgG threshold. Global authors & global audience, including insurance & healthcare funders.

2/ We delineate between these two: 🟢 Primary IVIG/SCIG PPx: Start during C1 regardless of IgG level 🔴 Preemptive IgG replacement: Restrict IVIG/SCIG until IgG < 400 mg/dL (4 g/L) 😳 IgG levels can be misleading and don't guarantee protection against circulating pathogens.

3/ Some would argue that we'd need RCT of primary PPx versus preemptive replacement (give if IgG <400 mg/dL) to prove tihs. Our counterpoint - writing's already on the wall. Infection risk with bsAbs in #MMsm (esp BCMA) much too high, and IgG 400 not scientifically based.

4/ For concerning safety risk, effective strategies worthwhile even if expensive. No RCT needed, just like no RCT ever done re: toci for CRS. IVIG quite expensive, but benefits outweigh costs here given ⬆️⬆️ risk of Gr3+ infections. Global perspective 👇🏼 SCIG may be a winner!

5/ Thanks to amazing co-authors Meera Mohan Kai Rejeski Gurbakhash Kaur Shonali Midha, M.D. Georgia McCaughan Nikhil Kumar Nikita Mehra Bhausaheb Bagal for 🌏 perspective & mentor Noopur Raje for wisdom. Bottom line - if healthcare payers have the reaction below, show them our Blood Advances article!

6/ Link to #MMsm article in Blood Advances : ashpublications.org/bloodadvances/…

Rahul Banerjee, MD, FACP Blood Advances Noopur Raje Meera Mohan Kai Rejeski Gurbakhash Kaur Shonali Midha, M.D. Georgia McCaughan Nikita Mehra Bhausaheb Bagal Nikhil Kumar Even with talquetamab?

Nathan Punwani Blood Advances Noopur Raje Meera Mohan Kai Rejeski Gurbakhash Kaur Shonali Midha, M.D. Georgia McCaughan Nikita Mehra Bhausaheb Bagal Nikhil Kumar This is an excellent question that we struggled with. Ultimately, esp as tal increasingly combined with pom or dara, we concluded that benefits > risks. Other nuance was Kai Rejeski's analysis of NRM: similar for GPRC5D and BCMA bsAbs, so IVIG may help! cell.com/molecular-ther…

Congrats Rahul Banerjee, MD, FACP for this very important collabartive effort. Thank you for including me and our team at FMRI, Gurgaon for this important manuscript IVIG prophylaxis plays a significant role in Indian setting to reduce the incidence of infections with bispecifics in MM

🔍Proteinuria in monoclonal gammopathy? Don’t miss the diagnostic clues! 🚰uAPR < 40%? Think tubular 🧪uAPR > 40%? Glomerular path ahead From cast nephropathy to MGRS, biopsy is 🔑 📉LC ≤10%= cast nephropathy 📊LC >10%= #LCPT 🧬 #MGRS = Biopsy it 📖doi.org/10.1016/j.lpm.…

#Myeloma Paper of the Day: Targeting w/ talquetamab as bridge to BCMA CAR-T shows no grade ≥3 CRS, 2% grade 3 ICANS & grade 1-2 talq unique toxicities, 71% ORR, post CAR-T 88% responded/54% CR, 2 grade ≥3 CRS, 1 grade 3 ICANS, 5% grade ≥3 infxns: pubmed.ncbi.nlm.nih.gov/40749169/. #mmsm

#HomiBhabhaCancerConclave2025 #HBCC2025 #CancerConclave2025 MULTI-DISCIPLINARY MANAGEMENT OF COMMON CANCERS CALL FOR ABSTRACTS Last date of submission: 16/08/2025 Abstracts must be emailed to: [email protected] Dr. Ashish Gulia Tata Memorial Hospital DAE India Homi Bhabha Cancer Hospital & Research Centre Homi Bhabha Cancer Hospital, Sangrur

Listen, we have way too many doctors trying to do research. Stop it. Go see some patients.

As usual, masterfully written (no pun intended) by Luciano J Costa Smit Giri MD MHS et al. #MMsm sMRD- at 10^-5 performed better than sMRD- at 10^-6. Turned many heads at #ASH24. May be small n, or: 👇🏼 Maybe sMRD ≤10^-5 catches the most pts and gives us the prognostic info we need!

Full article now out in Blood Journals Portfolio by Smit Giri MD MHS Natalie Callander Bhagirath Dholaria, MD Susan Bal Luciano J Costa et al. Excellent work! ashpublications.org/blood/article/…

The S-MRD-5 vs. S-MRD-6 created some good questions and surprised some. It comes down to the difference between "what produces the best classifying model" and "what is the best result to have". They are often different things. To use an analogy, and still stay in MM: B2M 1/x