Humoral immune reconstitution following therapy with daratumumab, carfilzomib, lenalidomide, and dexamethasone (Dara‐KRd), autologous hematopoietic cell transplantation, and measurable residual disease‐response‐adapted treatment cessation

Author:

Silbermann Rebecca W.1ORCID,Schmidt Timothy Martin2ORCID,Bal Susan3,Dhakal Binod4,Dholaria Bhagirathbhai5,Biltibo Eden5,Chhabra Saurabh4,Giri Smith6,Godby Kelly N.3,Gowda Sonia7,Medvedova Eva1,Cornell Robert F.5,Callander Natalie S.2,Costa Luciano J.3

Affiliation:

1. Knight Cancer Institute Oregon Health and Science University Portland Oregon USA

2. Carbone Cancer Center University of Wisconsin Madison Wisconsin USA

3. University of Alabama at Birmingham Birmingham AL UK

4. Division of Hematology/Oncology, Department of Medicine Medical College of Wisconsin Milwaukee Wisconsin USA

5. Vanderbilt University Medical Center Nashville TN USA

6. Institute for Cancer Outcomes and Survivorship University of Alabama at Birmingham Birmingham AL UK

7. Department of Internal Medicine Oregon Health and Science University Portland Oregon USA

Abstract

AbstractQuadruplet induction, autologous hematopoietic cell transplant (AHCT), and measurable residual disease (MRD) response‐adapted consolidation yield an unprecedented depth of response in newly diagnosed multiple myeloma. Patients treated on MASTER (NCT03224507) ceased therapy and entered active surveillance (MRD‐SURE) after achieving MRD negativity. This study characterizes quantitative changes in the immunoglobulin (Ig) gene repertoire by next‐generation sequencing and serum gamma globulin levels. Quadruplet therapy leads to profound hypogammaglobulinemia and reduction in the Ig gene repertoire. Immune reconstitution (IR) is delayed in patients who received post‐AHCT consolidation compared to those who do not. Eighteen months after treatment cessation, there was no statistically significant difference between the groups.

Publisher

Wiley

Subject

General Earth and Planetary Sciences

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