Safety and efficacy of daratumumab in patients with multiple myeloma and severe renal failure

Kuzume, Ayumi; Tabata, Rikako; Terao, Toshiki; Tsushima, Takafumi; Miura, Daisuke; Narita, Kentaro; Takeuchi, Masami; Matsue, Kosei

doi:10.1111/bjh.17412

Cited by 19 publications

(16 citation statements)

References 9 publications

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“…In this study, the overall response rate was 40%, the median PFS was 8.74 months, and the median overall survival was 12.2 months with tolerable grade 3-4 adverse events of thrombocytopenia (n = 5), anemia (n = 4), and neutropenia (n = 4). In addition, in Japan, a case series of 13 RRMM patients with an eGFR <15 treated with Dara was reported [13]. In this report, 10 of 13 patients had a >50% reduction of involved FLC.…”

Section: Discussionmentioning

confidence: 65%

Isatuximab plus Pomalidomide and Dexamethasone in a Patient with Dialysis-Dependent Multiple Myeloma

Takakuwa

Ohta²,

Sogabe

et al. 2021

Chemotherapy

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The phase 3 ICARIA-MM trial showed that the addition of isatuximab improved the progression-free survival compared with pomalidomide/dexamethasone. However, the safety and efficacy of isatuximab for end-stage renal failure remains unclear. A 67-year-old man who started hemodialysis 5 years ago for diabetic nephropathy was diagnosed with International Staging System stage III multiple myeloma (MM) of IgD-λ type 3 years ago. After receiving a total of 7 treatment regimens, his free light chain (FLC) λ level increased from 419 to 2,070 mg/L, indicating progressive disease. Twelve days after starting isatuximab plus pomalidomide (3 mg daily) and dexamethasone (IsaPd), his FLC λ level rapidly decreased to 412 mg/L. The patient has now completed 7 courses of IsaPd with no adverse events, including infusion reactions and neutropenia. Isatuximab requires a lower dilution volume than daratumumab and can be safely and effectively administered to hemodialysis-dependent MM patients.

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Section: Discussionmentioning

confidence: 65%

Isatuximab plus Pomalidomide and Dexamethasone in a Patient with Dialysis-Dependent Multiple Myeloma

Takakuwa

Ohta²,

Sogabe

et al. 2021

Chemotherapy

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“…Notably, 3 of 6 previously dialysis-dependent patients achieved independence from dialysis. 10 The safety of daratumumab and its contribution to renal function improvement have also been emphasized in some case reports. 2,3,11 In our study, we similarly observed a degree of anti-myeloma efficacy, reporting complete remission in 1 patient and very good partial remission in 4 patients, respectively.…”

Section: Discussionmentioning

confidence: 99%

Experience of Daratumumab in Six Patients With Multiple Myeloma and Kidney Failure

Turgutkaya¹,

Bolaman²,

Yavaşoğlu³

2021

Clin Med�Insights�Blood�Disord

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Purpose Daratumumab, a monoclonal anti-CD38 antibody, has been administered for relapsed refractory multiple myeloma (RRMM). The Pollux and Castor trials proved its efficacy, yet excluded patients with advanced-stage renal disease. Therefore, available experience in these patients is limited. Here, we aimed to emphasize the safety of daratumumab in 6 patients with kidney disease. Methods Six patients with RRMM diagnoses and renal impairment were included. Their mean ± standard deviation age was 63.6 ± 8.38 years. Three, two, and one patient(s) had immunoglobulin (Ig) G kappa, lambda light chain, and IgA lambda MM, respectively. All patients received 4 to 6 lines of anti-MM therapy before daratumumab treatment. Five had chronic kidney disease and 1 was admitted to the hospital with acute kidney injury due to myeloma relapse. Daratumumab was administered to all patients with close follow-up. Results Following treatment with daratumumab, kidney function was improved in 1 patient. In 1 patient, the glomerular filtration rate was slightly decreased and hemodialysis was initiated. In 2 patients already receiving hemodialysis, their dependency on hemodialysis continued. No adverse reactions were recorded. One patient achieved complete remission and 4 patients achieved very good partial remission. Conclusion Daratumumab can be administered safely, with improvements in kidney function possible in some patients. Studies involving larger patient groups are required to obtain more accurate data.

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“…Real-world experience with daratumumab monotherapy has continuously been reported since its approval as a treatment for RRMM [ 10 - 13 ]. The studies highlighted that daratumumab monotherapy was safely administered to patients, including those who did not fit the clinical trials selection criteria.…”

Section: Discussionmentioning

confidence: 99%

Daratumumab monotherapy in relapsed and refractory multiple myeloma patients with severely compromised forced expiratory volume in one second

et al. 2022

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Safety and efficacy of daratumumab in patients with multiple myeloma and severe renal failure

Abstract: Cr, creatinine; dFLC, difference between involved free light chain (FLC) and uninvolved FLC; eGFR, estimated glomerular filtration rate; iFLC, involved FLC; NA, not available; no., number.

Cited by 19 publications

References 9 publications

Isatuximab plus Pomalidomide and Dexamethasone in a Patient with Dialysis-Dependent Multiple Myeloma

Isatuximab plus Pomalidomide and Dexamethasone in a Patient with Dialysis-Dependent Multiple Myeloma

Experience of Daratumumab in Six Patients With Multiple Myeloma and Kidney Failure

Daratumumab monotherapy in relapsed and refractory multiple myeloma patients with severely compromised forced expiratory volume in one second

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