Less-fit patients with significant comorbidities or advanced age (aged ≥80 years)

The less-fit patient may receive induction chemotherapy with a triplet or quadruplet regimen (as described for the patient in good or well-controlled health, but with dosage adjustments) including the CD38-directed monoclonal antibodies daratumumab or isatuximab, or with a doublet regimen including daratumumab or isatuximab, which might be better tolerated.[26] Therapy is continued until maximal response, and then maintenance therapy is given until relapse.[27] At relapse, subsequent therapies are given sequentially (as described for the patient in good or well-controlled health).