■在有移植资格的情况下,新诊断的多发性骨髓瘤(NDMM)患者,自体外周血干细胞(PBSC)采集通常在诱导治疗后进行.虽然诱导方案在反应方面不断完善,它们对PBSC收集的影响尚未充分研究。将抗CD38抗体达雷妥单抗纳入诱导治疗显著改善NDMM患者的预后,例如,作为达拉图单抗的一部分,硼替佐米,沙利度胺,和地塞米松(Dara-VTD)协议。来自3期CASSIOPEIA研究的初步数据证明了Dara-VTD的功效。虽然在研究人群中添加达雷妥单抗后的总体PBSC收集减少,缺少对影响的更详细分析。
■我们在此报告n=119例接受硼替佐米诱导治疗的NDMM患者的PBSC动员和收集指标,环磷酰胺,和地塞米松(VCD,n=61)或Dara-VTD(n=58)。
■组间患者特征平衡良好。Dara-VTD组显示出改善的反应参数,其中66%的患者达到至少非常好的部分反应,而VCD组为54%。Dara-VTD患者在第一次白细胞去除术(LP)时表现出较差的动员指标,例如外周血CD34细胞计数(65vs.106/μL,p=0.001),LP会议的中位数(2与1,p=0.001),和第一LP的PBSC收集(5.5与8.3×106/kg体重[bw],p=0.001)。在Dara-VTD之后,plerixafor的利用率略高(33%与21%的患者,p=0.143)。在Dara-VTD之后,总体PBSC收集结果显着降低(8.4与9.6×106/kgbw,p=0.026)。在Dara-VTD和VCD组中,78%和85%的患者成功收集了3例CD34细胞/kgbw≥2×106的移植物,分别。
■总之,Dara-VTD,可能是由于抗CD38抗体和沙利度胺暴露,对PBSC收集施加了限制,只能通过使用plerixafor部分克服。
UNASSIGNED: In transplant-eligible, newly diagnosed multiple myeloma (NDMM) patients, autologous peripheral blood stem cell (PBSC) collection is usually pursued after induction therapy. While induction regimens are constantly refined regarding response, their impact on PBSC collection is not fully studied. The inclusion of the anti-CD38 antibody daratumumab into induction therapy significantly improved outcomes for patients with NDMM, e.g., as part of the daratumumab, bortezomib, thalidomide, and dexamethasone (Dara-VTD) protocol. Preliminary data from the phase 3 CASSIOPEIA study proved the efficacy of Dara-VTD. While overall PBSC collection upon addition of daratumumab was reduced in the study population, more detailed analyses on the impact are missing.
UNASSIGNED: We here report on PBSC mobilization and collection metrics in n = 119 patients with NDMM who underwent induction therapy with bortezomib, cyclophosphamide, and dexamethasone (VCD, n = 61) or Dara-VTD (n = 58).
UNASSIGNED: Patient characteristics were well balanced between groups. The Dara-VTD group showed improved response parameters with 66% of patients reaching at least very good partial response versus 54% in the VCD group. Dara-VTD patients exhibited inferior mobilization metrics such as peripheral blood CD34+ cell count at the first leukapheresis (LP) session (65 vs. 106/μL, p = 0.001), median number of LP sessions (2 vs. 1, p = 0.001), and PBSC collection at first LP (5.5 vs. 8.3 × 106/kg body weight [bw], p = 0.001). Utilization of plerixafor was slightly higher after Dara-VTD (33% vs. 21% of patients, p = 0.143). The overall PBSC collection result was significantly lower after Dara-VTD (8.4 vs. 9.6 × 106/kg bw, p = 0.026). 78% and 85% of patients successfully collected 3 transplants with ≥2 × 106 CD34+ cells/kg bw in the Dara-VTD and the VCD groups, respectively.
UNASSIGNED: In summary, Dara-VTD, possibly due to both anti-CD38 antibody and thalidomide exposure, imposes a limitation on PBSC collection which can be only partly overcome by utilization of plerixafor.