Daratumumab is being increasingly integrated into first-line multiple myeloma (MM) induction regimens, leading to improved response depth and longer progression-free survival. Autologous stem cell transplantation (ASCT) is commonly performed as a consolidation strategy following first-line induction in fit MM patients. We investigated a cohort of 155 MM patients who received ASCT after first-line induction with or without daratumumab (RVd,n= 110; D-RVd,n= 45), analyzing differences in stem cell mobilization, apheresis, and engraftment. In the D-RVd group, fewer patients successfully completed mobilization at the planned apheresis date (44% vs. 71%,p= 0.0029), and more patients required the use of rescue plerixafor (38% vs. 28%,p= 0.3052). The median count of peripheral CD34+ cells at apheresis was lower (41.37 vs. 52.19 × 106/L,p= 0.0233), and the total number of collected CD34+ cells was inferior (8.27 vs. 10.22 × 106/kg BW,p= 0.0139). The time to recovery of neutrophils and platelets was prolonged (12 vs. 11 days,p= 0.0164; and 16 vs. 14 days,p= 0.0002, respectively), and a higher frequency of erythrocyte transfusions (74% vs. 51%,p= 0.0103) and a higher number of platelet concentrates/patients were required (4 vs. 2;p= 0.001). The use of daratumumab during MM induction might negatively impact stem cell mobilization and engraftment in the context of ASCT.
达雷妥尤单抗正日益被整合进多发性骨髓瘤（MM）的一线诱导治疗方案中，从而提高了治疗反应的深度并延长了无进展生存期。自体干细胞移植（ASCT）通常作为体能状态良好的MM患者在一线诱导治疗后的巩固策略。我们研究了一组155名MM患者，他们在接受含或不含达雷妥尤单抗的一线诱导治疗后进行了ASCT（RVd方案组，n=110；D-RVd方案组，n=45），并分析了干细胞动员、单采和植入方面的差异。在D-RVd组中，在计划单采日成功完成动员的患者较少（44% vs. 71%，p=0.0029），需要挽救性使用普乐沙福的患者更多（38% vs. 28%，p=0.3052）。单采时外周血CD34+细胞的中位数计数较低（41.37 vs. 52.19 × 10^6/L，p=0.0233），采集的CD34+细胞总数也较少（8.27 vs. 10.22 × 10^6/kg 体重，p=0.0139）。中性粒细胞和血小板恢复时间延长（分别为12天 vs. 11天，p=0.0164；以及16天 vs. 14天，p=0.0002），并且红细胞输注频率更高（74% vs. 51%，p=0.0103），需要的浓缩血小板单位数/患者也更多（4 vs. 2；p=0.001）。在MM诱导治疗期间使用达雷妥尤单抗可能会对ASCT背景下的干细胞动员和植入产生负面影响。
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