Real-world data on the use of subcutaneous daratumumab plus bortezomib, thalidomide, and dexamethasone in transplant-eligible patients with newly diagnosed multiple myeloma

Ann Hematol. 2025 May;104(5):2787-2798. doi: 10.1007/s00277-025-06365-3. Epub 2025 Apr 30.

Abstract

Subcutaneous daratumumab in combination with bortezomib, thalidomide, and dexamethasone (D-VTd), is approved for transplant-eligible patients with newly diagnosed multiple myeloma (NDMM). However, additional real-world data are needed to assess the effectiveness and safety of D-VTd in routine clinical practice. We conducted a noninterventional, multicenter, observational study across hematology centers in Brazil to gather real-world data on D-VTd in patients with NDMM who were eligible for autologous stem cell transplant (ASCT). Eligible patients must have completed 1 or more cycle of D-VTd, on or before September 30, 2022, to be included. Data were collected retrospectively from the start of D-VTd to the study inclusion visit using patient medical records and prospectively thereafter using electronic case report forms. As of the data cutoff (August 8, 2023), 49 patients were included. By the end of consolidation, 91.7% of patients achieved an overall response (partial response or better) and 89.6% achieved very good partial response or better. Forty-five (91.8%) patients underwent stem cell mobilization with a median stem cell yield of 5.7 × 106 CD34+ cells/kg, and 44 (89.8%) patients underwent ASCT, among whom 43 out of 44 (97.7%) successfully completed ASCT. D-VTd was well tolerated, with a safety profile consistent with that previously known for daratumumab and VTd. Grade 3/4 neutropenia/febrile neutropenia and infections were reported in 32.7% and 18.4% of patients, respectively. Overall, results were consistent with the established profile of D-VTd, and these real-world effectiveness and safety results support the frontline use of subcutaneous daratumumab plus VTd in transplant-eligible patients with NDMM.

Keywords: Autologous stem cell transplant; Daratumumab; Multiple myeloma; Real-world; Subcutaneous.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal* / administration & dosage
  • Antibodies, Monoclonal* / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols* / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols* / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Bortezomib / administration & dosage
  • Bortezomib / adverse effects
  • Dexamethasone / administration & dosage
  • Dexamethasone / adverse effects
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Injections, Subcutaneous
  • Male
  • Middle Aged
  • Multiple Myeloma* / diagnosis
  • Multiple Myeloma* / drug therapy
  • Multiple Myeloma* / therapy
  • Retrospective Studies
  • Thalidomide / administration & dosage
  • Thalidomide / adverse effects

Substances

  • daratumumab
  • Dexamethasone
  • Bortezomib
  • Thalidomide
  • Antibodies, Monoclonal