Cytomegalovirus infection during daratumumab therapy in patients with newly diagnosed multiple myeloma

Abstract

Abstract The introduction of daratumumab has improved the treatment outcomes for multiple myeloma (MM). However, infectious complications such as pneumonia are a concern in patients receiving daratumumab. Although some reports have explored the association between daratumumab and cytomegalovirus (CMV) infection, most of these have focused on relapsed or refractory cases. There are few reports on patients with newly diagnosed MM (NDMM). In this study, we retrospectively analyzed CMV infections in 53 patients with NDMM who received daratumumab as induction therapy. CMV infection was defined as CMV antigenemia positivity. Patients who did not undergo CMV antigenemia testing were considered to have no CMV infection. The frequency of CMV infection was calculated as the cumulative incidence rate, considering death during daratumumab administration without CMV infection as a competing event. The median age at treatment initiation was 71 years (range, 50–82 years), and 50.9% of the patients were female. The median duration of daratumumab administration was 10.0 months (range, 0.3–63.8 months). Nine patients developed CMV infection, and the cumulative incidence rate at six months was 18.1% (95% confidence interval: 8.9–30.1%). One patient experienced CMV retinitis and required antiviral therapy, while the remaining eight patients did not require treatment and could be managed through observation. During daratumumab treatment for NDMM, very few cases of CMV infection required treatment. However, the incidence of CMV infection was relatively high, suggesting that regular monitoring of CMV is worth considering for more appropriate management with daratumumab treatment.