Frontline Daratumumab Triplet Demonstrates Durability in Octogenarians but

A retrospective real-world study at Kitasato University Hospital evaluated frontline daratumumab, lenalidomide, and dexamethasone (DRd) in patients older than 80 with transplant-ineligible newly diagnosed multiple myeloma. Among 24 consecutive patients identified from December 1, 2019, to October 31, 2025, 15 received DRd. The regimen produced an overall response rate of 93.3% and an estimated median treatment duration of 36.7 months, but infectious complications—especially severe infections during the first 12 months—frequently disrupted treatment continuation. Exploratory analyses suggested baseline nutritional vulnerability was associated with higher severe infection rates and earlier treatment interruption. The findings underscore the need to manage host vulnerability and early infection risk to maintain durability in routine care.