Daratumumab maintenance after autologous hematopoietic stem cell transplantation for newly diagnosed multiple myeloma
10.3760/cma.j.issn.0253-2727.2023.12.008
- VernacularTitle:新诊断多发性骨髓瘤自体造血干细胞移植后达雷妥尤单抗维持治疗的临床观察
- Author:
Yi MA
1
;
Xiubin XIAO
;
Xilin CHEN
;
Shunzong YUAN
;
Yun LU
;
Shihua ZHAO
;
Junli CHEN
;
Guangning SHI
;
Yueqi WANG
;
Nana CHENG
;
Pan FENG
;
Mingshuang DING
;
Wenrong HUANG
Author Information
1. 解放军总医院第五医学中心血液病医学部淋巴瘤-浆细胞疾病专科，北京 100071
- Keywords:
Multiple myeloma;
Daratumumab;
Autologous stem cell transplantation;
Maintenance therapy
- From:
Chinese Journal of Hematology
2023;44(12):1016-1021
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aimed to evaluate the efficacy and safety of daratumumab as a maintenance treatment after autologous hematopoietic stem cell transplantation (auto-HSCT) in patients with newly diagnosed multiple myeloma (NDMM) .Methods:The clinical data, hematological and renal response, and safety of 15 post-transplant patients with NDMM who had received daratumumab maintenance between May 1, 2022 and June 30, 2023 were retrospectively analyzed.Results:Fifteen patients (11 males and 4 females) with a median age of 58 (41-72) years were included. Thirteen patients did not receive daratumumab during induction therapy and auto-HSCT, 6 patients had renal impairment, and nine patients had high-risk cytogenetics. The median infusion of daratumumab was 12 (6-17) times, and the median duration of maintenance was 6 (1.5-12) months. The treatment efficacy was evaluated in all 15 patients, and daratumumab maintenance therapy increased the rate of stringent complete response from 40% to 60%. The renal response rate and median estimated glomerular filtration rate of six patients with RI-NDMM were also improved. During daratumumab maintenance therapy, the most common hematological grade 3 adverse event (AE) was lymphopenia [4 of 15 patients (26.67%) ], whereas the most common nonhematologic AEs were infusion-related reactions [7 of 15 patients (46.67%) ] and grade 3 pneumonia [5 of 15 patients (33.33%) ]. The five patients with pneumonia were daratumumab naive [5 of 13 patients (38.46%) ], with a median of 8 (6-10) infusions. Among them, the chest computed tomography of three patients showed interstitial infiltrates, and treatment with methylprednisolone was effective. With a median follow-up of 12 months, the 1-year overall survival rate was 93.33%, and only one patient died (which was not related to daratumumab treatment) .Conclusions:Daratumumab was safe and effective as a maintenance agent for post-auto-HSCT patients with NDMM, and AEs were controllable. The most common nonhematologic AE was grade 3 pneumonia, and a less dose-intense maintenance regimen for the first 8 weeks could reduce the incidence of pneumonia.
