Meta-analysis of the prognostic efficacy of daratumumab combined with standard therapy in high-risk multiple myeloma

This meta-analysis aims to evaluate the efficacy of daratumumab (DAR) in combination with standard therapy for the treatment of high-risk multiple myeloma (HRMM), offering evidence-based insights to guide clinical decision-making. A comprehensive search was conducted across literature databases to identify studies investigating the use of DAR in HRMM. After removing duplicates, titles, abstracts, and full texts were screened. Study quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions (version 5.1.0). Studies with high risk of bias were excluded. Data on authors, publication dates, study populations, objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and adverse events were analyzed using RevMan 5.3 software. 11 studies were included, comprising 2330 patients in the control group (standard therapy) and 2663 patients in the experimental group (DAR plus standard therapy). All studies were rated as having a low to moderate risk of bias. Meta-analysis showed that ORR, PFS, and OS were significantly higher in the experimental group (P < 0.05). The incidence of anemia was lower in the DAR group, while thrombocytopenia and neutropenia were more frequent (P < 0.05). Funnel plot analysis suggested minimal publication bias. The combination of DAR with standard therapy significantly enhances clinical outcomes in HRMM patients, resulting in prolonged PFS and OS, with manageable adverse effects.