Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Hematol and Elmer Press Inc
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Original Article

Volume 14, Number 6, December 2025, pages 314-323

Efficacy and Safety of Daratumumab, Lenalidomide and Dexamethasone Therapy in the First Relapse of Multiple Myeloma Patients – Real World Data from Hungary

Figures

↓  Figure 1. Study design.
Figure 1.
↓  Figure 2. OS and PFS results in the whole intent-to-treat population. OS: overall survival; PFS: progression-free survival.
Figure 2.
↓  Figure 3. OS and PFS results according to R-ISS. OS: overall survival; PFS: progression-free survival; R-ISS: Revised International Staging System.
Figure 3.
↓  Figure 4. OS and PFS results according to cytogenetic alterations. OS: overall survival; PFS: progression-free survival.
Figure 4.
↓  Figure 5. OS and PFS results according to frailty status. OS: overall survival; PFS: progression-free survival.
Figure 5.
↓  Figure 6. OS and PFS results according to previous APSCT. APSCT: autologous peripheral stem cell transplantation; OS: overall survival; PFS: progression-free survival.
Figure 6.
↓  Figure 7. OS and PFS results according to previous lenalidomide exposure. OS: overall survival; PFS: progression-free survival.
Figure 7.

Tables

↓  Table 1. Demographic and Clinical Characteristics of the Patient Population
 
Characteristic
APSCT: autologous peripheral stem cell transplantation; D-Rd: daratumumab, lenalidomide, and dexamethasone; Ig: immunoglobulin; R-ISS: Revised International Staging System.
Age at treatment onset (years), median (range) 65 (41 - 78)
Gender, n (%)
  Male 26 (47)
  Female 29 (53)
Frailty status, n (%)
  Frail 26 (47)
  Non-frail 29 (53)
Type of measurable disease, n (%)
  IgG 29 (52.7)
  IgA 14 (25.4)
  Light-chain 12 (21.9)
R-ISS disease staging, n (%)
  I 16 (29)
  II 11 (20)
  III 28 (51)
Prior treatments, n (%)
  Bortezomib 54(98)
  Thalidomide 17 (31)
  Alkylating agent 24 (44)
  APSCT 23 (43)
  Lenalidomide maintenance 9 (16)
Pre-D-Rd cytogenetic profile, n (%)
  Standard risk cytogenetic abnormality 25/53 (47.1))
  High risk cytogenetic abnormality 28/53 (52.9)

 

↓  Table 2. Adverse Events
 
Grade 1 - 2 Grade 3 Grade 4 Grade 5
Neutropenia 25 4
Thrombocytopenia 18 3
Anemia 16 1
Infections 15 1 1 3
Gastrointestinal 20
Infusion-related 32
All 126 9 1 3

 

↓  Table 3. Comparison of Baseline Patient Characteristics Across Clinical Trials Evaluating the Efficacy of D-Rd Therapy in Relapsed or Refractory Multiple Myeloma
 
POLLUX trial Czech Myeloma Group data US real-world data Hungarian National trial
aR-ISS staging system was used. D-Rd: daratumumab, lenalidomide, and dexamethasone; R-ISS: Revised International Staging System.
Number of patients 286 224 214 55
Previous treatment lines 1 - 9 1 - 3 1 - 4+ 1
Age 65 (34 - 89) 65.5 (45.0 - 77.8) 68.6 (41.2 - 83.4) 65 (41 - 78)
ISS stages, n (%)
  1 137 (48) 89 (48.4) 50 (23.4) 16 (29)
  2 93 (32) 41 (22.3) 42 (19.6) 11 (20)
  3 56 (20) 54 (29.3) 46 (21.5) 28 (51)a
  Unknown 40 (17.8) 76 (35.5)
Cytogenetic alterations, n (%) Not reported
  Standard 193 (67) 163 (76.2) 25 (45)
  High-risk 35 (12) 32 (15) 28 (51)
  Unknown 58 (21) 19 (8.9) 2 (4)
Frailty status, n (%) Not reported Not reported
  Frail 35 (16.4) 26 (47)
  Non-frail 179 (83.6) 29 (53)