Analysis of efficacy and prognostic influencing factors of daratumumab in treatment of multiple myeloma
10.3760/cma.j.cn115356-20231211-00098
- VernacularTitle:多发性骨髓瘤达雷妥尤单抗治疗效果及预后影响因素分析
- Author:
Fei XIN
1
;
Xuliang SHEN
;
Mingxia WEI
;
Guoxiang ZHANG
Author Information
1. 长治医学院附属和平医院血液科，长治 046000
- Keywords:
Multiple myeloma;
Daratumumab;
Treatment outcome;
Prognosis
- From:
Journal of Leukemia & Lymphoma
2024;33(7):405-410
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical efficacy of daratumumab-containing regimen in the treatment of multiple myeloma (MM) and the associated factors affecting patients' progression-free survival (PFS).Methods:A retrospective case series study was conducted. Clinical data of 21 MM patients who were treated with daratumumab-containing regimen in the Heping Hospital Affiliated to Changzhi Medical College from January 2021 to September 2023 were collected. The patients were treated with daratumumab (16 mg/kg intravenous drip) combined with other drugs for 28 d as 1 cycle until disease progression. Among the 21 cases, 6 cases were newly diagnosed multiple myeloma (NDMM), 7 cases were relapsed/refractory multiple myeloma (RRMM), and 8 cases were second-line treatment with daratumumab after the poor outcome of VRD (bortezomib + lenalidomide +dexamethasone) regimen at the time of initial treatment (daratumumab second-line treatment group). The efficacy of the patients after 2 cycles of daratumumab treatment was summarized; the PFS of the whole group and the NDMM and RRMM patients was analyzed by using Kaplan-Meier method, and log-rank test was used for comparison between the groups; the different status of disease, gender and age were included in the univariate and multivariate Cox proportional hazards models to screen the factors affecting the PFS of MM patients.Results:The median age [ M ( Q1, Q3)] of 21 patients was 62 years old (55 years old, 68 years old); 17 were male and 4 were female. After 2 cycles of daratumumab treatment, the overall remission rate (ORR) of the whole group was 85.7% (18/21), 2 cases (9.5%) achieved strict complete remission (sCR), 3 cases (14.3%) achieved complete remission (CR), 9 cases (42.9%) achieved very good partial remission (VGPR), 4 cases (19.0%) achieved partial remission (PR), 2 cases (9.5%) had stable disease and 1 case (4.8%) had disease progression. After 2 cycles of daratumumab treatment, all 6 NDMM patients were in remission, with 2 cases of sCR, 1 case of CR, and 3 cases of VGPR; 4 of 7 RRMM patients were in remission, with 1 case of CR and 3 cases of PR; 8 patients with daratumumab second-line treatment were in remission, with 1 case of CR, 6 cases of VGPR, and 1 case of PR; the difference in ORR among the 3 groups was statistically significant ( P = 0.010), the difference in ORR between patients with NDMM and daratumumab second-line treatment was not statistically significant ( P = 0.245), the ORR of NDMM patients was higher than that of RRMM patients, and the difference was statistically significant ( P = 0.029). The median follow-up time was 15.4 months (95% CI: 13.7-17.1 months). The median PFS time for the whole group was 10.6 months (95% CI: 7.3-15.5 months); the median PFS time was not reached in NDMM patients, the median PFS time was 14.6 months (95% CI: 2.1-27.2 months) in RRMM patients, the median PFS time was 9.6 months (95% CI: 9.5-9.7 months) in patients with daratumumab second-line treatment, and the difference in PFS among the 3 groups was not statistically significant ( P = 0.085). Multivariate Cox regression analysis showed that high age was an independent risk factor for PFS in MM patients ( HR = 1.12, 95% CI: 1.03-1.21, P = 0.009). Conclusions:Daratumumab has good results in treating MM and can be used as a first-line treatment option for NDMM patients, which may improve the remission rate of MM patients with previous ineffective treatment of VRD regimen, and may also improve the prognosis of RRMM patients. High age may be a risk factor for disease progression in MM patients treated with daratumumab.
