Objective To analyze the effect of basic chemotherapy regimen of daratumumab combined with bortezomib in stratification for myeloma and risk⁃adapted therapy (mSMART) patients with high⁃risk multiple myeloma. Methods Clinical data of 87 high⁃risk multiple myeloma patients with mSMART score ≥4 were retrospectively analyzed, and according to therapeutic regimens, they were divided into control group (60 cases, receiving bortezomib basic chemotherapy regimen) or observation group (27 cases, receiving daratumumab combined with bortezomib basic chemotherapy regimen). The pre⁃ and post⁃treatment Numeric Rating Scale (NRS) score for pain, Karnofsky Perfomance Scale (KPS) score, CD4+/CD8+ ratio, and CD4+ and CD3+ levels, as well as post⁃treatment clinical efficacy, adverse reactions, and prognosis were compared between the two groups. Results After treatment, the NRS scores for pain in the two groups were lower than those before treatment, and the KPS score, CD4+/CD8+ ratio, and CD4+ and CD3+ levels were higher than those before treatment, and the NRS score for pain in the observation group was lower than that in the control group, whereas the KPS score, CD4+/CD8+ ratio, and CD4+ and CD3+ levels were higher than those in the control group (P<0.05). The total clinical effective rate of the observation group was higher than that of the control group (P<0.05). During treatment, there was no statistically significant difference in the incidence rate of adverse reactions between the two groups (P>0.05). At 2 years of follow⁃up, the survival rate of the observation group was higher than that of the control group (P<0.05). Conclusion Basic chemotherapy regimen of daratumumab combined with bortezomib for the treatment of mSMART patients with high⁃risk multiple myeloma is superior to bortezomib basic chemotherapy regimen, which can reduce pain degree, improve immune function and quality of life, improve short⁃term survival rate of patients, exerting a good safety.

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