Predictive role of absolute lymphocyte count in daratumumab-treated patients with relapsed/ refractory multiple myeloma
- Author:
Hee Jeong CHO
1
;
Jae-Cheol JO
;
Yoo Jin LEE
;
Myung Won LEE
;
Do Young KIM
;
Ho Jin SHIN
;
Sung Nam IM
;
Ji Hyun LEE
;
Sung Hwa BAE
;
Young Rok DO
;
Won Sik LEE
;
Min Kyung KIM
;
Jina JUNG
;
Jung Min LEE
;
Ju-Hyung KIM
;
Dong Won BAEK
;
Sang-Kyun SOHN
;
Joon Ho MOON
Author Information
- Publication Type:2
- From:The Korean Journal of Internal Medicine 2023;38(2):238-247
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:Daratumumab has shown an encouraging antitumor effect in patients with multiple myeloma (MM), and was known to alter the immune properties by off-targeting immunosuppressive cells. Here, we aimed to evaluate the change in absolute lymphocyte count (ALC) as a surrogate marker for predicting survival outcomes of patients treated with daratumumab.
Methods:Between 2018 and 2021, the medical records of patients with relapsed/refractory MM (RRMM) treated with daratumumab monotherapy at 10 centers in South Korea were reviewed. We collected the ALC data at pre-infusion (D0), day 2 after the first infusion (D2), and prior to the third cycle of daratumumab therapy (D56).
Results:Fifty patients who were administered at least two cycles of daratumumab were included. Overall response rate was 54.0% after two cycles of daratumumab treatment. On D2, almost all patients experienced a marked reduction in ALC. However, an increase in ALC on D56 (ALCD56) was observed in patients with non-progressive disease, whereas failure of ALC recovery was noted in those with progressive disease. Patients with ALCD56 > 700/μL (n = 39, 78.0%) had prolonged progression- free survival (PFS) and overall survival (OS) than those with ALCD56 ≤ 700/μL (median PFS: 5.8 months vs. 2.6 months, p = 0.025; median OS: 24.1 months vs. 6.1 months, p = 0.004). In addition, ALCD56 >700/μL was a significant favorable prognostic factor for PFS (hazard ratio [HR], 0.22; p = 0.003) and OS (HR, 0.23; p = 0.012).
Conclusions:Increase in ALC during daratumumab treatment was significantly associated with prolonged survival outcomes in patients with RRMM. The ALC value can predict clinical outcomes in patients treated with daratumumab.
