Yin Ling-Ling, Shen Yang-Ling, Min Feng-Ling, Gu Wei-Ying, Wang Ying, Qi Kun-Ming, Li Zhen-Yu, Xu Kai-Lin
Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, Jiangsu Province, China.
Department of Hematology, The Third Affiliated Hospital of Suzhou University(The First People's Hospital of Changzhou), Changzhou 213003, Jiangsu Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2023 Feb;31(1):141-147. doi: 10.19746/j.cnki.issn.1009-2137.2023.01.023.
To investigate the efficacy and safety of daratumumab in treatment of multiple myeloma (MM) patients with renal impairment (RI).
The clinical data of 15 MM patients with RI who received daratumumab-based regimen from January 2021 to March 2022 in three centers were retrospectively analyzed. Patients were treated with daratumumab or daratumumab combined with dexamethasone or daratumumab combined with bortezomib and dexamethasone and the curative effect and survival were analyzed.
The median age of 15 patients was 64 (ranged 54-82) years old. Six patients were IgG-MM, 2 were IgA-MM,1 was IgD-MM and 6 were light chain MM. Median estinated glomerular filtration rate (eGFR) was 22.48 ml/(min·1.73 M). Overall response rate of 11 patients with MM was 91% (≥MR), including 1 case of stringent complete response (sCR), 2 cases of very good partial response (VGPR), 3 cases of partial response (PR) and 4 cases of minor response (MR). The rate of renal response was 60%(9/15), including 4 cases of complete response (CR), 1 case of PR and 4 cases of MR. A median time of optimal renal response was 21 (ranged 7-56) days. With a median follow-up of 3 months, the median progression-free survival and overall survival of all patients were not reached. After treatment with daratumumab-based regimen, grade 1-2 neutropenia was the most common hematological adverse reaction. Non-hematological adverse reactions were mainly infusion-related adverse reactions and infections.
Daratumumab-based regimens have good short-term efficacy and safety in the treatment of multiple myeloma patients with renal impairment.
探讨达雷妥尤单抗治疗肾功能损害（RI）的多发性骨髓瘤（MM）患者的疗效和安全性。
回顾性分析2021年1月至2022年3月在三个中心接受以达雷妥尤单抗为基础方案治疗的15例RI-MM患者的临床资料。患者接受达雷妥尤单抗或达雷妥尤单抗联合地塞米松或达雷妥尤单抗联合硼替佐米及地塞米松治疗，并分析疗效和生存情况。
15例患者的中位年龄为64岁（范围54-82岁）。6例为IgG-MM，2例为IgA-MM，1例为IgD-MM，6例为轻链MM。中位估计肾小球滤过率（eGFR）为22.48 ml/（min·1.73 m²）。11例MM患者的总缓解率为91%（≥MR），包括1例严格完全缓解（sCR）、2例非常好的部分缓解（VGPR）、3例部分缓解（PR）和4例微小缓解（MR）。肾脏缓解率为60%（9/15），包括4例完全缓解（CR）、1例PR和4例MR。最佳肾脏缓解的中位时间为21天（范围7-56天）。中位随访3个月，所有患者的中位无进展生存期和总生存期均未达到。以达雷妥尤单抗为基础的方案治疗后，1-2级中性粒细胞减少是最常见的血液学不良反应。非血液学不良反应主要是输注相关不良反应和感染。
以达雷妥尤单抗为基础的方案治疗肾功能损害的多发性骨髓瘤患者具有良好的短期疗效和安全性。
