Hematologic and systemic complications of bispecific antibodies: Insights from a National Inpatient Study.

Abstract

e24121 Background: Bispecific antibodies have revolutionized cancer treatment but are associated with a distinct toxicity profile. This study explores real-world outcomes, highlighting demographic trends, treatment complications, and clinical predictors of adverse events using National Inpatient Sample data from 2018 to 2021. Methods: A retrospective analysis was conducted on 61,890 patients treated with bispecific antibodies across U.S. hospitals. Data on comorbidities, complications, and outcomes were stratified by year, patient demographics, and hospital characteristics. Logistic regression determined associations between clinical factors and adverse events, with results expressed as odds ratios (ORs) and confidence intervals (CIs). Results: Neutropenia emerged as the most frequent complication (14.32 OR in 2021, p < 0.001), followed by thrombocytopenia and anemia. Tumor lysis syndrome (TLS) showed a rising trend, peaking in 2021 (OR: 58.58, p < 0.001). Protective factors included elective admissions and female gender, while advanced age, anemia, and CKD increased the likelihood of complications. Toxic encephalopathy, though less common, peaked at 413 cases in 2020, reflecting potential neurotoxic effects of therapy. Urban teaching hospitals accounted for most admissions (95%), and routine discharge was achieved in 76% of cases. Conclusions: The findings emphasize the need for vigilant monitoring of hematologic and systemic complications, especially TLS and neutropenia, in patients receiving bispecific antibodies. Targeted management protocols for older adults and individuals with preexisting anemia or CKD may mitigate treatment-related risks.