STEM CELL YIELD AND TRANSPLANTATION IN TRANSPLANT-ELIGIBLE NEWLY DIAGNOSED MULTIPLE MYELOMA PATIENTS RECEIVING DARATUMUMAB + BORTEZOMIB/THALIDOMIDE/DEXAMETHASONE (D-VTD): PHASE 3 CASSIOPEIA STUDY
Author(s): ,
Cyrille Hulin
Affiliations:
Department of Hematology, Hospital Haut Leveque, University Hospital Bordeaux,Pessac,France
,
Philippe Moreau
Affiliations:
Hematology, University Hospital Hôtel-Dieu,Nantes,France
,
Michel Attal
Affiliations:
Institut Universitaire du Cancer de Toulouse-Oncopole,Toulouse,France
,
Karim Belhadj
Affiliations:
Hematology, Hopital Henri Mondor,Creteil,France
,
Lotfi Benboubker
Affiliations:
CHU de Tours, Hôpital de Bretonneau,Tours, Cedex 9,France
,
Denis Caillot
Affiliations:
CHU Dijon, Hôpital Du Bocage,Dijon,France
,
Thierry Facon
Affiliations:
Service des Maladies du Sang, Hôpital Claude Huriez,Lille,France
,
Laurent Garderet
Affiliations:
Sorbonne Université, Centre de Recherche Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Département d'Hématologie et de Thérapie Cellulaire, Hôpital Pitié Salpetrière, département d'hématologie,Paris,France
,
Frédérique Kuhnowski
Affiliations:
Institut Curie Paris,Paris,France
,
Anne-Marie Stoppa
Affiliations:
Institut Paoli Calmettes,Marseille Cedex 9,France
,
Brigitte Kolb
Affiliations:
Hôpital Robert Debré, CHU de Reims,Reims Cedex,France
,
Mourad Tiab
Affiliations:
CHD Vendée,La Roche sur Yon Cedex 9,France
,
Pieter Sonneveld
Affiliations:
Erasmus MC Cancer Institute,Rotterdam,Netherlands
,
Kon-Siong Jie
Affiliations:
Zuyderland MC,Sittard,Netherlands
,
Matthijs Westerman
Affiliations:
Northwest Clinics,Alkmaar,Netherlands
,
Lixia Pei
Affiliations:
Janssen Research & Development,Raritan, NJ,United States
,
Tobias Kampfenkel
Affiliations:
Janssen Research & Development, LLC,Leiden,Netherlands
,
Carla de Boer
Affiliations:
Janssen Research & Development, LLC,Leiden,Netherlands
,
Jessica Vermeulen
Affiliations:
Janssen Research & Development, LLC,Leiden,Netherlands
Niels W.C.J. van de Donk
Affiliations:
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Hematology,Amsterdam,Netherlands
EHA Library. Hulin C. Jun 14, 2019; 266397; PF598
Cyrille Hulin
Cyrille Hulin
Contributions
Abstract

Abstract: PF598

Type: Poster Presentation

Presentation during EHA24: On Friday, June 14, 2019 from 17:30 - 19:00

Location: Poster area

Background
High-dose therapy (HDT) followed by autologous stem-cell transplantation (ASCT) is the standard of care in transplant-eligible newly diagnosed multiple myeloma (NDMM). In the phase 3 CASSIOPEIA study, daratumumab + standard-of-care regimen VTd (D-VTd) significantly improved stringent complete response (sCR), complete response or better (≥CR), and minimal residual disease (MRD)-negative rates and reduced the risk of progression or death versus VTd in NDMM patients who were eligible for transplant.

Aims
Here, we assessed stem cell yield and transplantation results among patients receiving D-VTd versus VTd induction prior to HDT and ASCT in Part 1 of the CASSIOPEIA trial.

Methods
In Part 1, transplant-eligible NDMM patients ages 18-65 years were randomized 1:1 to 4 pre-transplant induction and 2 post-transplant consolidation cycles of D-VTd or VTd alone. After induction, patients underwent stem cell mobilization with cyclophosphamide 3 g/m2 (recommended dose) and granulocyte colony-stimulating factor (G-CSF). Peripheral blood stem cells were harvested based on response to mobilization. Plerixafor was administered if stem cell collection failed at first attempt and in accordance with institutional practice. Melphalan 200 mg/m2 IV was given as HDT prior to ASCT.

Results
A total of 1,085 patients were randomized to D-VTd (n = 543) or VTd (n = 542). Among patients who completed mobilization (D-VTd, 506; VTd, 492), more patients in the D-VTd arm received plerixafor during mobilization than in the VTd arm (21.7% vs 7.9%). Patients underwent a median (range) of 2 (1-6) versus 1 (1-4) days of apheresis for D-VTd versus VTd. The median number of CD34+ cells collected was lower in patients receiving D-VTd versus VTd (6.3×106/kg vs 8.9×106/kg). Nevertheless, a similar percentage of intention-to-treat patients receiving D-VTd versus VTd underwent ASCT (90.1% vs 89.3%). The median number of CD34+ cells transplanted for D-VTd versus VTd was 3.3×106/kg versus 4.3×106/kg. Hematopoietic reconstitution rates were high and similar in transplanted patients receiving D-VTd versus VTd (99.8% vs 99.6%). For D-VTd versus VTd, a median (range) of 13.0 (6-54) versus 13.0 (4-43) days was required to achieve sustained absolute neutrophil counts >500 cells/mm3, and a median (range) of 14.0 (2-56) versus 12.0 (1-47) days was required to achieve sustained platelets >20,000 cells/mm3 without transfusion.

Conclusion
Stem cell mobilization and collection was feasible with D-VTd induction. Adding daratumumab to VTd allowed successful transplantation in patients with NDMM who were transplant eligible.

Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical

Keyword(s): Monoclonal antibody, Multiple myeloma, Stem cell transplant

By clicking “Accept Terms & all Cookies” or by continuing to browse, you agree to the storing of third-party cookies on your device to enhance your user experience and agree to the user terms and conditions of this learning management system (LMS).

Cookie Settings
Accept Terms & all Cookies