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First-line daratumumab shows high efficacy and tolerability even in advanced AL amyloidosis: the real-world experience
- Source :
- ESMO Open
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- 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 therapeutics Results 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.<br />Highlights • Daratumumab yields high hematologic response rates in untreated AL amyloidosis. • Treatment is well tolerated even in advanced disease stages. • No unexpected toxicity was observed.
- Subjects :
- Cancer Research
medicine.medical_specialty
Transplantation, Autologous
Gastroenterology
Autologous stem-cell transplantation
Internal medicine
AL amyloidosis
medicine
Humans
Immunoglobulin Light-chain Amyloidosis
Adverse effect
Multiple myeloma
Retrospective Studies
Original Research
amyloidosis
business.industry
Amyloidosis
Hematopoietic Stem Cell Transplantation
Antibodies, Monoclonal
Daratumumab
light chain
daratumumab
medicine.disease
Hematologic Response
AL
Treatment Outcome
Oncology
Tolerability
immunotherapy
business
Subjects
Details
- ISSN :
- 20597029
- Volume :
- 6
- Database :
- OpenAIRE
- Journal :
- ESMO Open
- Accession number :
- edsair.doi.dedup.....9fbb5fee986af411d2c596783bc2e4c7