Profile and predictors of severe infectious complications with daratumumab-based regimens for multiple myeloma

Daratumumab-based regimens can improve the oncological outcomes of newly diagnosed or relapsed/refractory multiple myeloma (NDMM, RRMM), but are also associated with increased risk of severe infectious complications (ICs). A retrospective study at the Medical University of Lodz (Poland) investigated the profile and predictors of ICs with daratumumab-based regimens for NDMM and RRMM. The study included 49 NDMM patients and 90 RRMM patients. Most NDMM patients (98%) received daratumumab-bortezomib-thalidomide-dexamethasone (DVTd) , whereas the majority of the RRMM patients (60%) received DVd. Overall, 55 patients (39.6%) experienced ICs; 25 patients (18%) experienced severe ICs (grade 3 or higher) and 8 patients (6%) died due to ICs. In multivariable analysis ECOG performance status higher than 1 was associated with increased risk of ICs in both NDMM and RRMM, while normal hemoglobin levels were associated with decreased risk of ICs. The authors conclude that simple clinical and laboratory assessments can be valuable in identifying patients vulnerable to infections receiving daratumumab-based regimens for multiple myeloma.