Successful use of frontline daratumumab lenalidomide and dexamethasone in transplant ineligible frail patients with moderate renal failure at the time of presentation

Abstract

Introduction: Treatment of the elderly patients who have varying degrees of renal failure at the time of presentation, both due to the underlying plasma cell dyscrasia or the other comorbidities is a true challenge regarding the management of toxicities while trying to achieve the best durable responses. Daratumumab Lenalidomide and Dexamethasone (DRd) induction in transplant ineligible patient population is approved among the appealing results of MAIA trial. Lenalidomide is an immunomodulatory agent which is eliminated through kidneys and should potentially threat kidney function. But recently, PrE1003 trial showed that even patients with severe renal insuffi ciency should tolerate higher doses of the drug label.