Background:Daratumumab (DARA), lenalidomide (LEN), and dexamethasone (DEX, DRd) are one of standards of care for patients with multiple myeloma (MM); however, the clinical impact of relative dose intensity (RDI) remains unclear. In this retrospective study, the aim was to analyze the relationship between the RDI and clinical outcomes in patients with myeloma treated with DRd.Methods:The numbers of patients with newly diagnosed, relapsed, and/or refractory MM were 40 and 71, respectively.Results:The median patient age was 74 years, and the median RDIs for DARA, LEN, and DEX were 84.0%, 39.4%, and 14.6%, respectively. At a median 26.8 months follow-up interval, the 2-year time to the next treatment (TTNT) of the high RDI of DARA (cutoff, 90%) was greater than that of the low RDI of DARA (77.3% vs. 51.6%,p< 0.001), and the 2-year overall survival (OS) of the low RDI of DEX (cutoff, 15%) was longer than that of the high RDI of DEX (87.7% vs. 61.0%,p= 0.027). Multivariate analysis showed that a high RDI for DARA and low RDI for DEX were associated with longer TTNT and OS (hazard ratio, 0.503,p= 0.044; hazard ratio 0.426,p= 0.022, respectively). The high RDI of DARA and low RDI of DEX reduced the incidence of severe infections (p= 0.040 and 0.049).Conclusion:The high RDI of DARA and low RDI of DEX predicted good clinical outcomes in this study’s cohort.
背景：达雷妥尤单抗（DARA）、来那度胺（LEN）和地塞米松（DEX）组成的DRd方案是多发性骨髓瘤（MM）的标准治疗方案之一，但相对剂量强度（RDI）的临床影响尚不明确。本回顾性研究旨在分析接受DRd治疗的骨髓瘤患者RDI与临床结局之间的关系。 方法：新诊断、复发和/或难治性MM患者分别为40例和71例。 结果：患者中位年龄为74岁，DARA、LEN和DEX的中位RDI分别为84.0%、39.4%和14.6%。在中位26.8个月的随访期内，DARA高RDI组（临界值90%）的2年下次治疗时间（TTNT）优于DARA低RDI组（77.3% vs. 51.6%，p<0.001），而DEX低RDI组（临界值15%）的2年总生存期（OS）长于DEX高RDI组（87.7% vs. 61.0%，p=0.027）。多变量分析显示，DARA高RDI和DEX低RDI与更长的TTNT和OS相关（风险比分别为0.503，p=0.044；0.426，p=0.022）。DARA高RDI和DEX低RDI还降低了严重感染的发生率（p值分别为0.040和0.049）。 结论：在本研究队列中，DARA高RDI和DEX低RDI预示着良好的临床结局。
Relative Dose Intensity of Daratumumab, Lenalidomide, and Dexamethasone in Multiple Myeloma
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