Martino Massimo, Gori Mercedes, Porto Gaetana, Policastro Giorgia, Pitea Martina, Sgarlata Annalisa, Delfino Ilaria Maria, Cogliandro Francesca, Scopelliti Anna, Utano Giovanna, Pellicano Maria, Idato Aurora, Vincelli Iolanda Donatella, Marafioti Violetta, Micò Maria Caterina, Lazzaro Giuseppe, Loteta Barbara, Alati Caterina, Leanza Giovanni, D'Arrigo Graziella, Tripepi Giovanni Luigi, Pitino Annalisa
Hematology and Stem Cell Transplantation and Cellular Therapies Unit (CTMO), Department of Hemato-Oncology and Radiotherapy, Grande OspedaleMetropolitano"Bianchi-Melacrino-Morelli", 89133 Reggio Calabria, Italy.
Stem Cell Transplant Program CIC587, 89124 Reggio Calabria, Italy.
Cancers (Basel). 2024 Sep 27;16(19):3307. doi: 10.3390/cancers16193307.
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).
Sixty consecutive NDMM patients received four cycles of induction therapy with D-VTd. The conditioning regimen consisted of melphalan 200 mg/m. These patients were compared with a historical control group of 80 patients who received four cycles of VTd as induction therapy.
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, = 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.
Our real-life study showed that a four-drug induction therapy containing DARA does not impact transplant safety outcomes.
本真实世界研究旨在调查D-VTd诱导疗法对自体干细胞移植（auto-SCT）后造血植入的可能影响。
60例连续的新诊断多发性骨髓瘤（NDMM）患者接受了4个周期的D-VTd诱导治疗。预处理方案包括美法仑200mg/m²。这些患者与80例接受4个周期VTD诱导治疗的历史对照组进行比较。
接受D-VTd治疗的患者（分别为11天和13天）与接受VTD治疗的患者（10天和12天）达到中性粒细胞和血小板植入的中位天数有显著差异。单因素Cox分析显示，接受D-VTd治疗的患者中性粒细胞植入的风险比显著低于VTD组患者（HR：0.58，P = 0.002），多因素模型证实了这一结果。接受D-VTd治疗的患者发生发热性中性粒细胞减少（FN）的频率更高。单因素和多因素逻辑回归显示D-VTd与FN之间存在关联。植入延迟与更长时间的住院无关。移植后前6个月无患者死亡。
我们的真实世界研究表明，包含达雷妥尤单抗（DARA）的四联诱导疗法不会影响移植安全结局。
