PGY2 Adult Oncology Pharmacy Resident Memorial Sloan Kettering Lake View, New York, United States
Poster Abstract:
Background: The introduction of daratumumab into frontline therapy for newly diagnosed multiple myeloma (NDMM) patients has significantly enhanced treatment response. Previous studies have reported higher rates of infection in patients receiving dara-RVd (daratumumab, lenalidomide, bortezomib, and dexamethasone), but did not report on venous thromboembolism (VTE) rates in detail.1 This study aims to determine if there is a difference in the incidence of VTE and infections with dara-RVd versus RVd (lenalidomide, bortezomib, and dexamethasone).
Objective: The primary objectives of this study are to compare the rates of VTE and hospitalizations due to infections during first-line induction with dara-RVd versus RVd in patients with NDMM.
Methods: This single-center, retrospective, IRB approved study included NDMM patients ≥ 18 years of age treated at Memorial Sloan Kettering between January 1st, 2014 and December 31st, 2023 with dara-RVd or RVd as initial induction therapy and received concurrent VTE prophylaxis with aspirin and/or DOAC. Patients were excluded if they received less than 1 cycle of RVd or dara-RVd or received anticoagulation for other clinical indications. Primary endpoints were VTE rates and infections leading to inpatient administration of anti-infectives occurring from cycle 1, day 1 of induction treatment until 90 days after last dose of induction or at 1 year, whichever was shorter, in patients that did not receive a stem cell transplant within 1 year, or until day of transplant in patients that did receive a transplant. Secondary endpoints included bleeding rates, median time to onset of VTE and infections, and immunoglobulin levels at time of infections. Descriptive statistics were utilized to describe demographics, and both primary and secondary outcomes were compared via chi-square or Fischer’s exact test.
Results: A total of 224 patients met inclusion criteria; 121 (54%) patients received RVd and 103 (46%) patients received dara-RVd. VTEs occurred in 3 (2.5%) patients on RVd and 7 (6.8%) of patients on dara-RVd (p = 0.19). Infections occurred in 12 (9.9%) patients on RVd and 14 (13.6%) patients on dara-RVd (p = 0.41). Additional results and statistical analysis of secondary endpoints are pending.
Conclusion: Final results, analysis, and conclusions of our study are pending.
References (must also be included in final poster): 1. Voorhees PM, Kaufman JL, Laubach J, Sborov DW, Reeves B, Rodriguez C, Chari A, Silbermann R, Costa LJ, Anderson LD, Nathwani N, Shah N, Efebera YA, Holstein SA, Costello C, Jakubowiak A, Wildes TM, Orlowski RZ, Shain KH, Cowan AJ, Murphy S, Lutska Y, Pei H, Ukropec J, Vermeulen J, de Boer C, Hoehn D, Lin TS, Richardson PG. Daratumumab, lenalidomide, bortezomib, and dexamethasone for transplant-eligible newly diagnosed multiple myeloma: the GRIFFIN trial. Blood. 2020 Aug;136(8):936-945.
