First-line daratumumab shows high efficacy and tolerability even in advanced AL amyloidosis: the real-world experience

ESMO Open

article

G. Jeryczynski¹  M. Antlanger²  F. Duca³  C. Binder-Rodriguez³  T. Reiter⁴  I. Simonitsch-Klupp⁵  D. Bonderman³  R. Kain⁵  M.-T. Krauth⁶  H. Agis¹ 

[1]Division of Oncology, Department of Internal Medicine I, Medical University of Vienna

[2]Department of Internal Medicine 2, Kepler University Hospital, Johannes Kepler University Linz

[3]Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna

[4]Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna

[5]Department of Pathology, Medical University of Vienna

[6]Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna

关键词: amyloidosis;    AL;    light chain;    immunotherapy;    daratumumab;   

DOI  :  10.1016/j.esmoop.2021.100065

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Background Daratumumab was the first monoclonal CD38 antibody with single-agent activity approved for the treatment of multiple myeloma. Moreover, daratumumab demonstrated high response rates in relapsed immunoglobulin light-chain (AL) amyloidosis.Patients and methods In our single-center retrospective real-life case series, we analyzed the efficacy and safety of daratumumab as first-line treatment. Daratumumab was administered with low-dose dexamethasone alone or in combination with other multiple myeloma therapeuticsResults Fourteen patients were eligible, including nine patients with cardiac stage IIIa or IIIb. Overall hematologic response rate was 100%, with 64.3% achieving complete response after a median of 16 cycles of treatment. Median time to hematologic response was 1.4 months. Organ response rates were 45.5% after a median of 4.0 months and 66.7% after a median of 10.0 months, for heart and kidney involvement, respectively. After a median follow-up of 20.5 months, two patients underwent successful autologous stem cell transplantation (ASCT), while another three patients were in preparation for ASCT. Three patients remained on daratumumab at the last follow-up. There were no unexpected toxicities and no grade III or IV adverse events, although more than half of our patients were in stage IIIa or IIIb.Conclusion Daratumumab proved to be highly effective in newly diagnosed AL amyloidosis with excellent hematologic and organ response rates, a remarkable safety profile, and good tolerability even in patients with advanced stage of disease.

【 授权许可】

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