Impact of daratumumab on stem cell mobilization and collection, engraftment and early post-transplant complications among multiple myeloma patients undergoing autologous stem cell transplantation

Leuk Lymphoma. 2023 Dec;64(13):2140-2147. doi: 10.1080/10428194.2023.2253479. Epub 2023 Sep 1.

Abstract

Autologous stem cell transplantation (ASCT) remains a standard therapy for multiple myeloma (MM) patients. Our study aimed to assess the impact of daratumumab-containing induction on stem cell (SC) mobilization, apheresis and hospitalization. We evaluated 200 newly diagnosed MM patients that were mobilized for SC collection and which received induction with (N = 40) or without daratumumab (N = 160). Dara group patients required more frequent use of plerixafor, larger collection volumes, and had lower SC yield. 87.5% (35/40) of dara group patients achieved the planned yield of ≥ 5 × 10^6 CD34+/kg for at least one transplant compared to 96.2% (154/160) of patients in the non-dara group. Dara group patients had delayed hematopoietic recovery (11 vs 10 days for PMN > 0.5 × 10E9/l), required more transfusions (4 vs 2 plts), prolonged hospitalization (20 vs 18 days), more febrile episodes and prolonged antibiotic administration. Despite daratumumab effect patients finally achieved a successful stem cell collection and proceeded to transplant.

Keywords: Hematologic recovery; infectious complications marrow and stem cell trasnplantation.

MeSH terms

  • Granulocyte Colony-Stimulating Factor
  • Hematopoietic Stem Cell Mobilization
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Heterocyclic Compounds* / pharmacology
  • Humans
  • Multiple Myeloma* / therapy
  • Transplantation, Autologous

Substances

  • daratumumab
  • Granulocyte Colony-Stimulating Factor
  • Heterocyclic Compounds