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KMID : 0338420230380020238
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The Korean Journal of Internal Medicine
2023 Volume.38 No. 2 p.238 ~ p.247
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Predictive role of absolute lymphocyte count in daratumumab-treated patients with relapsed/ refractory multiple myeloma
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Cho Hee-Jeong
Jo Jae-Cheol
Lee Yoo-Jin
Lee Myung-Won
Kim Do-Young
Shin Ho-Jin
Im Sung-Nam
Lee Ji-Hyun
Bae Sung-Hwa
Do Young-Rok
Lee Won-Sik
Kim Min-Kyung
Jung Jina
Lee Jung-Min
Kim Ju-Hyung
Baek Dong-Won
Sohn Sang-Kyun
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Abstract
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Background/Aims: Daratumumab has shown an encouraging antitumor effect in patients with multiple myeloma (MM), and was known to alter the immune properties by off-targeting immunosuppressive cells. Here, we aimed to evaluate the change in absolute lymphocyte count (ALC) as a surrogate marker for predicting survival outcomes of patients treated with daratumumab.
Methods: Between 2018 and 2021, the medical records of patients with relapsed/refractory MM (RRMM) treated with daratumumab monotherapy at 10 centers in South Korea were reviewed. We collected the ALC data at pre-infusion (D0), day 2 after the first infusion (D2), and prior to the third cycle of daratumumab therapy (D56).
Results: Fifty patients who were administered at least two cycles of daratumumab were included. Overall response rate was 54.0% after two cycles of daratumumab treatment. On D2, almost all patients experienced a marked reduction in ALC.
However, an increase in ALC on D56 (ALCD56) was observed in patients with non-progressive disease, whereas failure of ALC recovery was noted in those with progressive disease. Patients with ALCD56 > 700/μL (n = 39, 78.0%) had prolonged progression- free survival (PFS) and overall survival (OS) than those with ALCD56 ≤ 700/μL (median PFS: 5.8 months vs. 2.6 months, p = 0.025; median OS: 24.1 months vs. 6.1 months, p = 0.004). In addition, ALCD56 >700/μL was a significant favorable prognostic factor for PFS (hazard ratio [HR], 0.22; p = 0.003) and OS (HR, 0.23; p = 0.012).
Conclusions: Increase in ALC during daratumumab treatment was significantly associated with prolonged survival outcomes in patients with RRMM. The ALC value can predict clinical outcomes in patients treated with daratumumab.
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KEYWORD
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Multiple myeloma, Daratumumab, Lymphocyte count, Biomarkers, Survival analysis
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