Hematology · 2 h ago
Daratumumab-Containing Regimens Linked to Early Infection Risk in Myeloma
An individual patient-level meta-analysis of six randomized trials involving 2,989 patients with multiple myeloma found more infections with daratumumab-containing regimens than with control regimens. Infection risk was highest in the first three months, with elevated rates of severe and respiratory infections also observed.
- Infections were more frequent with daratumumab-containing regimens.
- Risk peaked during the first three months of treatment.
- Recurrent infections were more common over two years.
- Fewer than 20% with severe respiratory infections received immunoglobulin replacement.
This individual patient-level meta-analysis pooled six randomized trials comparing daratumumab-containing with non-daratumumab regimens in 2,989 patients with newly diagnosed or relapsed/refractory multiple myeloma. Investigators assessed infections over two years, including their severity, timing and recurrence.
Any-grade infections occurred in 79% of daratumumab-treated patients versus 61% of controls; grade 3 or higher infections occurred in 29% versus 20%. Infection rates peaked during the first three months (42% vs. 36%; p=0.001). After adjustment, daratumumab was associated with higher odds of grade 3 or higher infection by three months (OR 1.47, 95% CI 1.08–2.00) and a higher infection rate over two years (adjusted incidence rate ratio 1.60, 95% CI 1.47–1.73). Recurrent infections were also more frequent. Fewer than 20% of patients with severe respiratory infections received immunoglobulin replacement. The findings identify an early period of increased infection burden, but do not establish which preventive strategy is effective; full text was unavailable for review.
In practice
For patients with newly diagnosed or relapsed/refractory multiple myeloma receiving daratumumab-containing regimens, this pooled analysis of six randomized trials indicates greater infection burden than with non-daratumumab regimens, particularly during the first three months. The findings support attention to infection risk during this early treatment period, but the analysis does not establish the effectiveness of any specific prevention or monitoring approach. Its results combine different trial populations and regimens, and should not be interpreted as evidence to start immunoglobulin replacement routinely.
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British Journal of Haematology: Temporal trends in infectious risk among multiple myeloma patients treated with daratumumab: A meta‐analysis ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.