Background: This real-life study aimed to investigate the possible impact of D-VTd induction therapy on hematopoietic engraftment after autologous stem cell transplantation (auto-SCT). Methods: Sixty consecutive NDMM patients received four cycles of induction therapy with D-VTd. The conditioning regimen consisted of melphalan 200 mg/m2. These patients were compared with a historical control group of 80 patients who received four cycles of VTd as induction therapy. Results: The median days to reach neutrophil and platelet engraftment significantly differed between patients treated with D-VTd (11 and 13 days, respectively) and VTd (10 and 12 days). Univariate Cox analyses show that patients treated with D-VTd had a hazard ratio of neutrophil engraftment that was 42% significantly lower than those in the VTd arm (HR: 0.58,p= 0.002), and a multivariate model confirmed this result. Patients treated with D-VTd developed FN more frequently. Univariate and multivariate logistic regressions revealed an association between D-VTd and FN. Delayed engraftment did not correlate with more extended hospitalization. No patients died in the first six months after transplantation. Conclusions: Our real-life study showed that a four-drug induction therapy containing DARA does not impact transplant safety outcomes.
背景：本项真实世界研究旨在探讨D-VTd诱导治疗对自体干细胞移植后造血功能重建的潜在影响。方法：连续入组60例新诊断多发性骨髓瘤患者接受四个周期D-VTd方案诱导治疗，预处理方案采用200 mg/m²马法兰。将本组患者与历史对照组（80例接受四个周期VTd方案诱导治疗的患者）进行比较。结果：D-VTd治疗组患者中性粒细胞与血小板植入中位时间（分别为11天和13天）与VTd组（10天和12天）存在显著差异。单变量Cox分析显示，D-VTd组患者中性粒细胞植入风险比显著降低42%（HR: 0.58, p=0.002），多变量模型验证了这一结果。D-VTd组患者发热性中性粒细胞减少症发生率更高，单变量及多变量逻辑回归分析均证实D-VTd治疗与FN发生存在关联。造血重建延迟并未导致住院时间延长，所有患者在移植后六个月内均未发生死亡。结论：本真实世界研究表明，含达雷妥尤单抗的四药诱导治疗方案不影响移植安全性结局。
肿瘤(癌症)患者之家