Korean J Intern Med.
2023 Mar;38(2):238-247. 10.3904/kjim.2022.183.
Predictive role of absolute lymphocyte count in daratumumab-treated patients with relapsed/ refractory multiple myeloma
- Cho HJ1
- Jo JC2
- Lee YJ2
- Lee MW3
- Kim DY4
- Shin HJ4
- Im SN5
- Lee JH6
- Bae SH7
- Do YR8
- Lee WS9
- Kim MK10
- Jung J1
- Lee JM1
- Kim JH1
- Baek DW1
- Sohn SK1
- Moon JH
1
- Affiliations
-
- 1Department of Hematology/Oncology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
- 2Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
- 3Department of Hematology-Oncology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
- 4Department of Hematology-Oncology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
- 5Department of Hematology- Oncology, Inje University Haeundae Paik Hospital, Busan, Korea
- 6Department of Hematology-Oncology, Dong-A University Hospital, Busan, Korea
- 7Department of Hematology-Oncology, Daegu Catholic University Hospital, Daegu Catholic University School of Medicine, Daegu, Korea
- 8Department of Hematology-Oncology, Keimyung University School of Medicine, Daegu, Korea
- 9Department of Hematology-Oncology, Inje University Busan Paik Hospital, Busan, Korea
- 10Department of Hematology-Oncology, Yeungnam University Hospital, Daegu, Korea, Korea
- KMID: 2539976
- DOI: http://doi.org/10.3904/kjim.2022.183
Abstract
- 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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