| Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Hematol and Elmer Press Inc |
| Journal website https://www.thejh.org |
Original Article
Volume 12, Number 1, February 2023, pages 1-6
Adverse Hematological and Non-Hematological Events in Patients With Relapsed/Refractory Multiple Myeloma That Are Responsive to Daratumumab, Pomalidomide and Dexamethasone
Tables
| Characteristics | Responders (n = 72) | Non-responders (n = 25) |
|---|---|---|
| aHigh risk cytogenetics rearrangements as the following: t(4;14), t(14;16), t(14;20), del 17p, and 1q gain. R-ISS: revised international staging system; RRMM: relapsed/refractory multiple myeloma; DPd: daratumumab, pomalidomide, and dexamethasone; IgG: immunoglobulin G. | ||
| Gender, male/female | 43/29 | 14/11 |
| Age, years, median (range) | 66 (42 - 81) | 66(46 - 84) |
| Race, no. of patients (%) | ||
| Caucasian | 55 (76%) | 19 (76%) |
| African American | 14 (19%) | 5 (20%) |
| Asian | 2 (3%) | 0 |
| Hispanic | 1 (2%) | 1 (4%) |
| MM paraprotein, number of patients (%) | ||
| IgG | 43 (60%) | 17 (68%) |
| Non-IgG | 22 (30%) | 5 (20%) |
| Light chain | 7 (10%) | 3 (12%) |
| Baseline R-ISS stage, number of patients (%) | ||
| Stage I | 24 (33%) | 6 (24%) |
| Stage II | 27 (38%) | 8 (32%) |
| Stage III | 17 (23%) | 11 (44%) |
| Unknown | 4 (6%) | 0 |
| Cytogenetics, no. of patients (%) | ||
| High riska | 46 (64%) | 17 (68%) |
| Standard risk | 26 (36%) | 8 (32%) |
| Extramedullary disease | 17 (24%) | 10 (40%) |
| Median number of lines of therapy (range) | 2 (1 - 6) | 2 (1 - 4) |
| Number of DPd cycles (range) | 17 (2 - 58) | 4 (1 - 15) |
| Duration of therapy in months (range) | 18 (2 - 62) | 4 (1 - 16) |
| Prior autologous stem cell transplant (%) | 61 (84%) | 17 (68%) |
| All DPd patients (n = 97) | DPd patients who responded to treatment (n = 72) | DPd patients who did not respond to treatment (n = 25) | ||||
|---|---|---|---|---|---|---|
| All grades | Grade III/IV | All grades | Grade III/IV | All grades | Grade III/IV | |
| DPd: daratumumab, pomalidomide, and dexamethasone; LFT: liver function test; GI: gastrointestinal. | ||||||
| Leukopenia | 84 (87%) | 57 (59%) | 66 (92%) | 47 (65%) | 18 (72%) | 10 (40%) |
| Neutropenia | 84 (87%) | 72 (72%) | 66 (92%) | 57 (79%) | 18 (72%) | 15 (60%) |
| Lymphopenia | 82 (85%) | 51 (53%) | 64 (89%) | 40 (56%) | 18 (72%) | 11 (44%) |
| Anemia | 53 (55%) | 20 (21%) | 40 (56%) | 13 (18%) | 13 (52%) | 7 (28%) |
| Thrombocytopenia | 69 (71%) | 12 (12%) | 53 (74%) | 6 (8%) | 16 (64%) | 6 (24%) |
| Elevated LFT | 24 (25%) | 0 (0) | 17 (24%) | 0 (0) | 7 (28%) | 0 (0) |
| GI symptoms (diarrhea, nausea, vomiting) | 7 (7%) | 0 (0) | 7 (10%) | 0 (0) | 0 (0) | 0 (0) |
| Pneumonia | 14 (14%) | 14 (14%) | 12 (17%) | 12 (17%) | 2 (8%) | 2 (8%) |
| Peripheral neuropathy | 19 (20%) | 10 (10%) | 15 (21%) | 6 (8%) | 4 (16%) | 4 (16%) |
| Infusion-related reaction | 23 (24%) | 0 (0) | 19 (26%) | 0 (0) | 4 (16%) | 0 (0) |
| Adverse events | Number of patients required dose reduction in DPd responders (%) | Number of patients required dose reduction in DPd non-responders (%) |
|---|---|---|
| aFifty-five patients underwent dose reduction in the responding group. bFourteen patients required dose reduction in the those who did not respond to DPd. DPd: daratumumab, pomalidomide, and dexamethasone. | ||
| Hematological toxicity | 40 (73%) | 11 (79%) |
| Fatigue | 7 (13%) | 1 (7%) |
| Neuropathy | 8 (15%) | 3 (21%) |
| Pneumonia | 2 (4%) | 0 |
| Rash | 2 (4%) | 0 |
| Neutropenic fever | 1 (2%) | 0 |
| Diarrhea | 1 (2%) | 0 |