A real-life study of daratumumab combinations in newly diagnosed patients with light chain (AL) amyloidosis
- PMID: 38824453
- DOI: 10.1002/hon.3289
A real-life study of daratumumab combinations in newly diagnosed patients with light chain (AL) amyloidosis
Abstract
Daratumumab-based regimens are the new standard of care for newly diagnosed patients with AL amyloidosis based on the results of the ANDROMEDA study. However, real-world data on daratumumab efficacy in upfront therapy in unselected patients are scanty. In the framework of a prospective observational study, we investigated the efficacy and safety of daratumumab in 88 newly diagnosed patients, including subjects with IIIb cardiac stage (26%) or myeloma defining events (29%). Daratumumab was administered with bortezomib in 50 (56%) patients, lenalidomide in 31 (35%), and monotherapy in 7 (8%). The rate of serious adverse events was low (16%). The overall hematologic response rate was 75% with 52 (59%) patients attaining at least a very good partial response (VGPR) at six months. Amongst patients evaluable for organ response, the rate of cardiac and renal responses at 6 months was 31% and 21%, respectively. Comparing stage IIIb patients with the remaining ones, the rate of profound hematologic response was not significantly different (≥VGPR 57% vs. 59%, p 0.955) likewise the rate of cardiac (33% vs. 30%, p 0.340) and renal (40% vs. 16%, p 0.908) responses. Daratumumab-based regimens demonstrated to be safe and effective in treatment-naïve AL amyloidosis even in advanced stage disease.
Keywords: AL amyloidosis; cardiac staging; daratumumab; prognosis.
© 2024 John Wiley & Sons Ltd.
References
REFERENCES
-
- Merlini G, Dispenzieri A, Sanchorawala V, et al. Systemic immunoglobulin light chain amyloidosis. Nat Rev Dis Prim. 2018;4(1):38. https://doi.org/10.1038/s41572‐018‐0034‐3
-
- Palladini G, Schönland S, Merlini G, et al. The management of light chain (AL) amyloidosis in Europe: clinical characteristics, treatment patterns, and efficacy outcomes between 2004 and 2018. Blood Cancer J. 2023;13(1):19. https://doi.org/10.1038/s41408‐023‐00789‐8
-
- Palladini G, Merlini G. How I treat AL amyloidosis. Blood. 2022;139(19):2918‐2930. https://doi.org/10.1182/blood.2020008737
-
- Wechalekar AD, Cibeira MT, Gibbs SD, et al. Guidelines for non‐transplant chemotherapy for treatment of systemic AL amyloidosis: EHA‐ISA working group. Amyloid. 2022;30:1‐15. Published online. https://doi.org/10.1080/13506129.2022.2093635
-
- Sanchorawala V. Summary of the EHA‐ISA working group guidelines for high‐dose chemotherapy and stem cell transplantation for systemic AL amyloidosis. HemaSphere. 2022;6(2):e681. https://doi.org/10.1097/HS9.0000000000000681
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources