Effectiveness of D-Rd program in the first line therapy of a 75-year-old female patient with multiple myeloma with high-risk cytogenetics. Clinical observation

Multiple myeloma is a B-cell lymphoproliferative disorder. Morphological substrate of the disorder are plasma cells producing monoclonal immunoglobulin, and the disorder is characterized by heterogeneity of clinical manifestations. Due to the understanding of molecular and biological basics of multiple myeloma pathogenesis, significant success was achieved in treatment of the standard and high-risk cytogenetics groups including full remission. However, not all patients show long-term progression-free survival. Necessity of more accurate evaluation of the extent of antitumor response, prognosis of progression-free survival and recurrence development led to minimal residual disease (MRD) testing. The analysis is based on detection of phenotypically aberrant clonal plasma cells in bone marrow aspirate after drug treatment. Currently, MRD-negative status is a significant prognostic factor. In some studies, high effectiveness of daratumumab in achievement of MRD-negative status in elderly patients with newly diagnosed multiple myeloma was demonstrated.