{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:39:11Z","timestamp":1788439151302,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hematological Oncology"],"published-print":{"date-parts":[[2025,3]]},"abstract":"ABSTRACT<\/jats:title>\n This multicenter real\u2010world analysis evaluated the efficacy of isatuximab, pomalidomide, and dexamethasone (IsaPd) in 51 patients with multiple myeloma (MM) who were refractory to daratumumab (Dara\u2010R). The majority were under 70\u00a0years old (60.8%), predominantly female (56.9%), and heavily pretreated, with 74.5% being triple\u2010class refractory (TCR); 32.1% of the 28 patients with cytogenetic data had high\u2010risk abnormalities. The overall response rate (ORR) was 56.9%, including 3 patients with stringent complete response (sCR), 4 with CR, and 7 with very good partial response (VGPR). Neither age, number of prior therapies, TCR status, nor time from Dara refractoriness to IsaPd initiation significantly affected response rates.<\/jats:p>\n Median progression\u2010free survival (PFS) was 5.8\u00a0months, with a 12\u2010month PFS probability of 30.6%. Baseline hemoglobin (Hb) levels were a key predictor of PFS: patients with Hb\u00a0<\u00a011.8\u00a0g\/L had a 3.5\u2010fold increased risk of progression, with a median PFS of 4.6\u00a0months compared to 22\u00a0months in those with higher Hb.<\/jats:p>\n Median overall survival (OS) was 21.0\u00a0months, with a 12\u2010month OS probability of 63.4%. Lower Hb levels (<\u00a011\u00a0g\/L) were associated with a tenfold increased risk of mortality.<\/jats:p>\n Among the 28 patients who underwent FISH analysis, while no significant difference in mortality risk was observed, those with high\u2010risk cytogenetic abnormalities exhibited a nearly tenfold increased risk of disease progression.<\/jats:p>\n These results suggest that IsaPd offers a meaningful option for Dara\u2010R patients, with Hb levels serving as a critical predictor of both PFS and OS. However, PFS remains modest, underscoring the need for novel combination therapies.<\/jats:p>","DOI":"10.1002\/hon.70042","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T07:44:56Z","timestamp":1738568696000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Efficacy and Prognostic Indicators of Isatuximab, Pomalidomide, and Dexamethasone (IsaPd) in Daratumumab\u2010Refractory Multiple Myeloma Patients: A Multicenter Real\u2010World Study"],"prefix":"10.1002","volume":"43","author":[{"given":"Enrica Antonia","family":"Martino","sequence":"first","affiliation":[{"name":"Department of Onco\u2010hematology Hematology Unit Azienda Ospedaliera Annunziata Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Derudas","sequence":"additional","affiliation":[{"name":"Department of Hematology Businco Hospital Cagliari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Rossi","sequence":"additional","affiliation":[{"name":"Section of Hematology Catholic University Fondazione Policlinico Gemelli IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Stefanoni","sequence":"additional","affiliation":[{"name":"Hematology and Bone Marrow Transplant Unit Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Mangiacavalli","sequence":"additional","affiliation":[{"name":"Division of Hematology IRCCS Fondazione Policlinico San Matteo Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Zamagni","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna Istituto di Ematologia \u201cSer\u00e0gnoli\u201d Bologna Italy"},{"name":"Dipartimento di Scienze Mediche e Chirurgiche Universit\u00e0 di Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2749-7347","authenticated-orcid":false,"given":"Massimo","family":"Offidani","sequence":"additional","affiliation":[{"name":"Hematology Unit AOU delle Marche Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Furlan","sequence":"additional","affiliation":[{"name":"Division of Hematology Ospedale Ca' Foncello di Treviso Treviso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela Maria","family":"Quinto","sequence":"additional","affiliation":[{"name":"Haematology and Transplant Unit IRCCS \u2010 Istituto Tumori \u201cGiovanni Paolo II\u201d Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5641-231X","authenticated-orcid":false,"given":"Roberta","family":"Della Pepa","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery University Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3785-9824","authenticated-orcid":false,"given":"Giuseppe","family":"Bertuglia","sequence":"additional","affiliation":[{"name":"Division of Hematology Azienda Ospedaliero\u2010Universitaria Citt\u00e0 della Salute e della Scienza di Torino University of Torino Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3148-6608","authenticated-orcid":false,"given":"Emiliano","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Hematology Unit Azienda USL\u2010IRCCS di Reggio Emilia Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concetta","family":"Conticello","sequence":"additional","affiliation":[{"name":"Division of Hematology Azienda Policlinico\u2010S. 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