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<p>Combination therapy with daratumumab, lenalidomide, and dexamethasone (D-Rd) has greatly improved outcomes for transplant-ineligible newly diagnosed multiple myeloma (TIE-NDMM). Effective management of herpes zoster (HZ) and other infections is critical to maximize therapeutic benefit and to maintain treatment continuity. However, antiviral prophylaxis for HZ in TIE-NDMM patients receiving D-Rd has unclear efficacy, and is currently not covered by health insurance in Japan. In this study, we retrospectively analyzed the incidence of HZ in 40 TIE-NDMM patients treated with D-Rd. Nine patients (22.5%) developed HZ at a median period of 10.7&#xa0;months (range, 0.4–34.2&#xa0;months) after starting D-Rd. The cumulative HZ incidence at 12, 24, and 36&#xa0;months was 13.3%, 19.5%, and 28.6%, respectively. Development of HZ was not associated with patient characteristics, disease characteristics, or hematologic response. Our data indicate a high incidence of HZ in TIE-NDMM patients receiving D-Rd, and we anticipate that Japanese health insurance should soon cover prophylactic treatment of HZ in D-Rd.</p>

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Incidence of herpes zoster in transplant-ineligible patients with newly diagnosed multiple myeloma treated with daratumumab, lenalidomide, and dexamethasone

  • 期刊论文

  • 发表日期：

    2025年3月31日

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  • Yuichi Horigome,
  • Hirotoshi Kamata,
  • Yusuke Michishita,
  • Maki Yokoyama,
  • Noriyuki Tadera,
  • Kei Hayama,
  • Takahiro Suzuki

摘要

Combination therapy with daratumumab, lenalidomide, and dexamethasone (D-Rd) has greatly improved outcomes for transplant-ineligible newly diagnosed multiple myeloma (TIE-NDMM). Effective management of herpes zoster (HZ) and other infections is critical to maximize therapeutic benefit and to maintain treatment continuity. However, antiviral prophylaxis for HZ in TIE-NDMM patients receiving D-Rd has unclear efficacy, and is currently not covered by health insurance in Japan. In this study, we retrospectively analyzed the incidence of HZ in 40 TIE-NDMM patients treated with D-Rd. Nine patients (22.5%) developed HZ at a median period of 10.7 months (range, 0.4–34.2 months) after starting D-Rd. The cumulative HZ incidence at 12, 24, and 36 months was 13.3%, 19.5%, and 28.6%, respectively. Development of HZ was not associated with patient characteristics, disease characteristics, or hematologic response. Our data indicate a high incidence of HZ in TIE-NDMM patients receiving D-Rd, and we anticipate that Japanese health insurance should soon cover prophylactic treatment of HZ in D-Rd.