P-128: DARATUMUMAB- VTD VS VTD. PERI-TRANSPLANT EVALUATION.

Introduction: Multiple myeloma (MM) is the primary indication for autologous peripheral blood stem cell transplantation (PBSCT) worldwide. The combination of Daratumumab, Velcade, Thalidomide, Dexamethasone (DVTD) has been approved for induction treatment in newly diagnosed MM (MMND) patients eligible for PBSCT. Daratumumab is a human monoclonal antibody IgG1k that binds to the CD38 protein expressed at high levels on the surface of plasma cells, inhibiting their growth through various mechanisms of action.

Methods:

Objective: To evaluate if DVTD increases the risk of hematologic toxicity, the need for blood transfusions, and complications derived from this myelotoxicity (bleeding, mucositis, febrile neutropenia).

Materials and methods:: This is a series of 38 patients treated at our hospital from 2013 to March 2022. Twenty-nine patients received VTd and 9 patients received the DVTd regimen.
Conditioning regimen with MEL200 [MEL140 in patients with renal insufficiency].

Results: Clinical and biological characteristics were similar, with a mean age of 57.22 in the Daratumumab arm compared to 62.21 in the arm without Daratumumab, and a very similar distribution by gender: Females 44.8% (Daratumumab arm) and 55.5% (arm without Daratumumab), and Males 55.2% (Daratumumab arm) and 44.5% (arm without Daratumumab).
Hematologic toxicity: We did not find differences in the recovery of cytopenias, clinical toxicity, transfusion requirements, or number of days until medical discharge. Peripheral blood stem cell collection is adequate, with no significant differences in the number of apheresis sessions, but there are statistically significant differences in the use of plerixafor.

Conclusions: We observed a greater difficulty in collecting hematopoietic progenitor cells in patients receiving treatment with Daratumumab, requiring a higher administration of plerixafor. However, we did not find statistically significant differences in terms of toxicity. Therefore, we can conclude that DVTd treatment is effective and well-tolerated.