{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T06:13:06Z","timestamp":1761891186308,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hematology Reports"],"abstract":"<jats:p>Background\/Objectives: The role of daratumumab, lenalidomide, and dexamethasone (DRd) in autologous stem cell transplantation (ASCT)-eligible patients with multiple myeloma (MM) after first-line bortezomib, cyclophosphamide, and dexamethasone (VCd) treatment is not yet established. Methods: We retrospectively evaluated ASCT-eligible patients with MM who received second-line therapy with DRd after initial induction therapy with VCd between 2017 and 2023 (salvage group). For comparison, patients who successfully underwent per-protocol treatment with VCd induction, followed by ASCT during the same period, were selected (control group). Results: Eight patients with a median age of 61 years (range, 36\u201368 years) were included in the salvage group. After a median of 5 DRd cycles, the best response was partial response (PR) in two patients (25%) and a very good partial response (VGPR) in six (75%). All patients underwent ASCT, resulting in PR in one (13%), VGPR in four (50%), and stringent complete response in three (38%). Measurable residual disease (MRD) assessed using multicolor flow cytometry was negative in four patients (50%). The controls included thirteen patients with a median age of 60 years (range, 44\u201364 years). While most patients in both groups received various post-ASCT therapies, the post-ASCT 2-year time to the next treatment rate was slightly better in the salvage group than in the control group (88% vs. 49%, p = 0.089). However, hypogammaglobulinemia was more common in the salvage group (75% vs. 15%, p = 0.018). Conclusions: This small case series suggests that DRd is promising for ASCT-eligible patients with MM after VCd failure.<\/jats:p>","DOI":"10.3390\/hematolrep17060057","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:50:19Z","timestamp":1761785419000},"page":"57","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Role of Daratumumab, Lenalidomide, and Dexamethasone in Transplantation-Eligible Patients with Multiple Myeloma After the Failure of Bortezomib-Based Induction Therapy"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2161-2059","authenticated-orcid":false,"given":"Shun","family":"Ito","sequence":"first","affiliation":[{"name":"Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan"},{"name":"Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo 173-8610, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Hamada","sequence":"additional","affiliation":[{"name":"Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaru","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan"},{"name":"Department of Hematology, Kasukabe Medical Center, Kasukabe 344-8588, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Ichinohe","sequence":"additional","affiliation":[{"name":"Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan"},{"name":"Department of Hematology, Kasukabe Medical Center, Kasukabe 344-8588, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hironao","family":"Nukariya","sequence":"additional","affiliation":[{"name":"Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihide","family":"Endo","sequence":"additional","affiliation":[{"name":"Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuya","family":"Kurihara","sequence":"additional","affiliation":[{"name":"Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichi","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shimon","family":"Otake","sequence":"additional","affiliation":[{"name":"Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromichi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5837-6348","authenticated-orcid":false,"given":"Hideki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1538-3804","authenticated-orcid":false,"given":"Katsuhiro","family":"Miura","sequence":"additional","affiliation":[{"name":"Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1002\/ajh.27422","article-title":"Multiple myeloma: 2024 update on diagnosis, risk stratification, and management","volume":"99","author":"Rajkumar","year":"2024","journal-title":"Am. J. Hematol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1038\/leu.2009.26","article-title":"Cyclophosphamide, bortezomib and dexamethasone induction for newly diagnosed multiple myeloma: High response rates in a phase II clinical trial","volume":"23","author":"Reeder","year":"2009","journal-title":"Leukemia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1111\/bjh.14920","article-title":"Phase II study of bortezomib, cyclophosphamide, and dexamethasone as induction therapy in multiple myeloma: The DSMM XI trial","volume":"179","author":"Einsele","year":"2017","journal-title":"Br. J. Haematol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1056\/NEJMoa2204925","article-title":"Triplet therapy, transplantation, and maintenance until myeloma progression","volume":"387","author":"Richardson","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Handa, H., Ishida, T., Ozaki, S., Mori, A., Kato, K., and Iida, S. (2023). Treatment pattern and clinical outcomes in multiple myeloma patients in Japan using the Medical Data Vision claims database. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0283931"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1080\/17474086.2023.2246651","article-title":"Role of daratumumab in the frontline management of multiple myeloma: A narrative review","volume":"16","author":"Yadav","year":"2023","journal-title":"Expert. Rev. Hematol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1182\/blood-2015-12-687749","article-title":"Daratumumab depletes CD38+ immune regulatory cells, promotes T-cell expansion, and skews T-cell repertoire in multiple myeloma","volume":"128","author":"Krejcik","year":"2016","journal-title":"Blood"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"284","DOI":"10.3324\/haematol.2010.030759","article-title":"Towards effective immunotherapy of myeloma enhanced elimination of myeloma cells by combination of lenalidomide with the human CD38 monoclonal antibody daratumumab","volume":"96","author":"Bakker","year":"2011","journal-title":"Haematologica"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1056\/NEJMoa1607751","article-title":"Daratumumab, lenalidomide, and dexamethasone for multiple treatment","volume":"375","author":"Dimopoulos","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1016\/S1470-2045(21)00466-6","article-title":"Daratumumab, lenalidomide, and dexamethasone versus lenalidomide and dexamethasone alone in newly diagnosed multiple myeloma (Maia): Overall survival results from a randomized, open-label, phase 3 trial","volume":"22","author":"Facon","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Xu, T., Roose, J., Williamson, M., Sawas, A., Hong, W.J., Jin, H., Maignan, K., Rocci, A., Yousefi, K., and Kumar, S. (2023). RWD-derived responses in multiple myeloma. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0285125"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e328","DOI":"10.1016\/S1470-2045(16)30206-6","article-title":"International Myeloma Working Group consensus criteria for the response and minimal residual disease assessment in multiple myeloma","volume":"17","author":"Kumar","year":"2016","journal-title":"Lancet Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2989","DOI":"10.1007\/s00277-021-04634-5","article-title":"Minimal residual disease detection in multiple myeloma: Comparison between BML single-tube 10-color multiparameter flow cytometry and EuroFlow multiparameter flow cytometry","volume":"100","author":"Sato","year":"2021","journal-title":"Ann. Hematol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2863","DOI":"10.1200\/JCO.2015.61.2267","article-title":"Revised international staging system for multiple myelomas: A report from the International Myeloma Working Group","volume":"33","author":"Palumbo","year":"2015","journal-title":"J. Clin. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.3109\/10428194.2015.1121258","article-title":"Primary failure of bortezomib in newly diagnosed multiple myeloma understanding the magnitude, predictors, and significance","volume":"57","author":"Cohen","year":"2016","journal-title":"Leuk. Lymphoma"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1182\/blood.2024025746","article-title":"Daratumumab with lenalidomide as maintenance therapy after transplantation in newly diagnosed multiple myeloma: The AURIGA study","volume":"145","author":"Badros","year":"2025","journal-title":"Blood"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Medina-Herrera, A., Sarasquete, M.E., Jim\u00e9nez, C., Puig, N., and Garc\u00eda-Sanz, R. (2023). Minimal residual disease in multiple myeloma: Past, Present, and future. Cancers, 15.","DOI":"10.3390\/cancers15143687"},{"key":"ref_18","first-page":"2049","article-title":"Role of minimal residual disease assessment in multiple myeloma","volume":"109","author":"Szalat","year":"2024","journal-title":"Haematologica"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.transci.2013.06.005","article-title":"Comparison of the efficacy of peripheral blood stem cell mobilization using G-CSF alone between healthy donors and patients with haematological malignancies","volume":"49","author":"Kawamura","year":"2013","journal-title":"Transfus. Apher. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3839","DOI":"10.1007\/s00277-024-05683-2","article-title":"Effect of prior lenalidomide or daratumumab exposure on hematopoietic stem cell collection and reconstitution in multiple myeloma","volume":"103","author":"Duan","year":"2024","journal-title":"Ann. Hematol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.1200\/JCO.22.00940","article-title":"Overall survival with daratumumab, lenalidomide, and dexamethasone in previously treated multiple myeloma (POLLUX): A randomized, open-label, Phase III trial","volume":"41","author":"Dimopoulos","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1038\/s41408-024-01107-6","article-title":"IgG replacement in multiple myeloma","volume":"14","author":"Wonnaparhown","year":"2024","journal-title":"Blood Cancer J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1111\/bjh.19578","article-title":"Response adaptive salvage treatment with daratumumab\u2013lenalidomide\u2013dexamethasone for newly diagnosed transplant-eligible multiple myeloma patients failing front-line bortezomib-based induction therapy\u2014ALLG MM21","volume":"205","author":"Lim","year":"2024","journal-title":"Br. J. Haematol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"307.e1","DOI":"10.1016\/j.jtct.2022.03.020","article-title":"Impact of induction with VCD versus VRD induction on the outcomes of patients with multiple myeloma after autologous hematopoietic stem cell transplantation","volume":"28","author":"Afrough","year":"2022","journal-title":"Transplant. Cell Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1056\/NEJMoa2312054","article-title":"Daratumumab, bortezomib, lenalidomide, and dexamethasone for multiple treatment","volume":"390","author":"Sonneveld","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"83.e1","DOI":"10.1016\/j.jtct.2021.10.022","article-title":"Impact of Induction Therapy with VRD versus VCD on Outcomes in Patients with Multiple Myeloma in Partial Response or Better Undergoing Upfront Autologous Stem Cell Transplantation","volume":"28","author":"Sidana","year":"2022","journal-title":"Transplant. Cell Ther."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1111\/bjh.19353","article-title":"The role of maintenance therapy following autologous stem cell transplantation in newly diagnosed multiple myeloma: Considerations on behalf of the Chronic Malignancies Working Party of the EBMT","volume":"204","author":"Hwang","year":"2024","journal-title":"Br. J. Haematol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1080\/14737167.2025.2461636","article-title":"Autologous stem cell transplantation and maintenance therapy for transplant-eligible multiple myeloma patients: Cost-effectiveness analysis based on a network meta-analysis","volume":"25","author":"Wu","year":"2025","journal-title":"Expert. Rev. Pharmacoecon Outcomes Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1080\/17474086.2025.2525457","article-title":"Maintenance therapy after ASCT in newly diagnosed multiple myeloma patients: Single agent versus combination drugs","volume":"18","author":"Martino","year":"2025","journal-title":"Expert Rev. Hematol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Kang, K.W., Kim, D.S., Lee, S.R., Heo, M.H., Eom, H.S., Jung, J., Lee, J.H., Kim, S.H., Koh, Y., and Min, C.K. (2025). Real-world outcomes of maintenance therapy post-autologous stem cell transplantation in newly diagnosed multiple myeloma. BMC Cancer, 25.","DOI":"10.1186\/s12885-025-13518-0"},{"key":"ref_31","unstructured":"Ito, S., Hamada, T., Nakagawa, M., Ichinohe, T., Nukariya, H., Endo, T., Kurihara, K., Takeuchi, Y., Otake, S., and Takahashi, H. (2025, January 23\u201325). Improving 1-Year MRD Negativity with DRd Therapy in VCd-Refractory Transplant-Eligible Multiple Myeloma Patients. Proceedings of the 50th Annual Meeting of the Japanese Society of Myeloma, Gunma, Japan."}],"container-title":["Hematology Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2038-8330\/17\/6\/57\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T04:17:04Z","timestamp":1761884224000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2038-8330\/17\/6\/57"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,29]]},"references-count":31,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["hematolrep17060057"],"URL":"https:\/\/doi.org\/10.3390\/hematolrep17060057","relation":{},"ISSN":["2038-8330"],"issn-type":[{"type":"electronic","value":"2038-8330"}],"subject":[],"published":{"date-parts":[[2025,10,29]]}}}