High prevalence of iron deficiency among daratumumab‐treated newly diagnosed multiple myeloma patients
Y. Lisa Hwa, Dragan Jevremovic, Karen Pak, Prashant Kapoor, Alissa Visram, Morie A. Gertz, David D. Dingli, Francis K. Buadi, Ronald S. Go, Rahma Warsame, Nelson Leung, Wilson I. Gonsalves, Miriam A. Hobbs, Amie L. Fonder, Joselle M. Cook, Moritz Binder, Suzanne R. Hayman, Taxiarchis Kourelis, S. Vincent Rajkumar, Angela Dispenzieri, Shaji K. Kumar, Eli MuchtarSummary
Iron deficiency (ID) is often overlooked in patients with haematological malignancies due to other potential aetiologies. Daratumumab, an anti‐cluster of differentiation 38 (anti‐CD38) monoclonal antibody, is commonly used for treating multiple myeloma (MM) in the upfront and relapsed/refractory settings. Although anaemia is a common haematological toxicity associated with daratumumab, the contribution of ID in MM patients has not been systematically investigated. We conducted a retrospective case–control study to evaluate the prevalence of ID in newly diagnosed MM (NDMM) patients. Cases were patients receiving daratumumab, ixazomib, lenalidomide and dexamethasone (Dara‐IRD, n = 55). We compared this group with an age‐ and sex‐matched cohort of patients with NDMM who received bortezomib, lenalidomide and dexamethasone (VRD, n = 20) as induction therapy. At 1‐year, nearly 50% of Dara‐IRD‐treated patients met the criteria for ID (ferritin <30 mcg/L) compared with none of the VRD‐treated controls. All Dara‐IRD‐treated patients had a decrease in ferritin at 1‐year from baseline compared with only 45% of VRD‐treated patients. These findings identify a marked clinical signal of ID among NDMM patients receiving daratumumab‐based treatment. Although the study design does not establish causality or exclude regimen‐related confounding, it highlights the need for increased awareness of the importance of monitoring iron status in MM patients treated with daratumumab‐containing regimens.