Daratumumab + Bortezomib + Lenalidomide + Dexamethasone (D-VRd), 4-6 induction cycles

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.

Source YAML: complete record

Components	`DRUG-DARATUMUMAB` `DRUG-BORTEZOMIB` `DRUG-LENALIDOMIDE` `DRUG-DEXAMETHASONE`

ID	`REG-DARA-VRD`
Type	Regimen
Status	reviewed 2026-04-25 \| pending_clinical_signoff
Diseases	None declared
Sources	`SRC-NCCN-MM-2025`

Notes

Quadruplet induction — preferred for transplant-eligible newly-diagnosed MM with high-risk cytogenetics, and increasingly the standard-of-care for all transplant-eligible patients per NCCN 2025 (PERSEUS, GRIFFIN trial data showing improved MRD-negativity rate). Always paired with HBV screening + entecavir prophylaxis if HBsAg+ or anti-HBc+, and pre-treatment red-cell phenotyping (daratumumab interferes with crossmatch).

Used By

Contraindications

CI-BORTEZOMIB-SEVERE-NEUROPATHY - CI-BORTEZOMIB-SEVERE-NEUROPATHY
CI-LENALIDOMIDE-PREGNANCY - CI-LENALIDOMIDE-PREGNANCY

Handbook Chapters

HB-MM-1L - Multiple myeloma: first-line risk and fitness reasoning

Indication

IND-MM-1L-DVRD - IND-MM-1L-DVRD

Regimen

REG-VRD - Bortezomib + Lenalidomide + Dexamethasone (VRd), 4-6 induction cycles

Supportive Care

SUP-HSV-PROPHYLAXIS - HSV / VZV prophylaxis during proteasome inhibitor therapy
SUP-MM-BONE-PROTECTION - Multiple myeloma bone protection (bisphosphonate)
SUP-MM-VTE-PROPHYLAXIS - VTE prophylaxis for IMiD-based myeloma therapy