Abstract
Introduction
Daratumumab, an anti-CD38 monoclonal antibody, has recently been approved by FDA and EMA for first-line treatment of systemic light chain (AL) amyloidosis in combination with cyclophosphamide, bortezomib and dexamethasone (Dara-CyBorD). In this case series we share our experience in treatment of AL amyloidosis with Dara-CyBorD.
Case series
From August 2022 to January 2024 overall 10 patients (6 female) with newly diagnosed AL amyloidosis received treatment with the Dara-CyBorD regimen. Age ranged from 44 to 74 years at the beginning of treatment (median 57 [IQR 53-62]). One patient was diagnosed in Mayo2004/European stage I, three patients in stages II, IIIA, IIIB each. Two patients (both stage IIIB) died due to complications associated with amyloid-related organ damage; 8 patients continue treatment. All patients achieved at least a very good partial hematologic response after the first cycle of Dara-CyBorD, 7 patients achieved complete response. In 5 cases, sustained organ response was achieved (cardiac in patients #1, #2, #5, #7; renal - #7, #9). Tolerability was acceptable, no serious adverse events were registered.
Conclusion
Daratumumab in combination with CyBorD has been demonstrated as a well-tolerated and effective therapy regimen for newly diagnosed AL amyloidosis. Rapid satisfactory hematologic responses were seen in all cases; sustained cardiac response was seen in select individuals regardless of initial disease stage.
Daratumumab, an anti-CD38 monoclonal antibody, has recently been approved by FDA and EMA for first-line treatment of systemic light chain (AL) amyloidosis in combination with cyclophosphamide, bortezomib and dexamethasone (Dara-CyBorD). In this case series we share our experience in treatment of AL amyloidosis with Dara-CyBorD.
Case series
From August 2022 to January 2024 overall 10 patients (6 female) with newly diagnosed AL amyloidosis received treatment with the Dara-CyBorD regimen. Age ranged from 44 to 74 years at the beginning of treatment (median 57 [IQR 53-62]). One patient was diagnosed in Mayo2004/European stage I, three patients in stages II, IIIA, IIIB each. Two patients (both stage IIIB) died due to complications associated with amyloid-related organ damage; 8 patients continue treatment. All patients achieved at least a very good partial hematologic response after the first cycle of Dara-CyBorD, 7 patients achieved complete response. In 5 cases, sustained organ response was achieved (cardiac in patients #1, #2, #5, #7; renal - #7, #9). Tolerability was acceptable, no serious adverse events were registered.
Conclusion
Daratumumab in combination with CyBorD has been demonstrated as a well-tolerated and effective therapy regimen for newly diagnosed AL amyloidosis. Rapid satisfactory hematologic responses were seen in all cases; sustained cardiac response was seen in select individuals regardless of initial disease stage.
Original language | English |
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Article number | 359 |
Pages (from-to) | S149 |
Number of pages | 1 |
Journal | Amyloid: The Journal of Protein Folding Disorders |
Volume | 31 |
Issue number | Suppl.1 |
Publication status | Published - 23 May 2024 |
Event | XIX International Symposium on Amyloidosis - Mayo Civic Center, Rochester, United States Duration: 26 May 2024 → 30 May 2024 Conference number: 19 https://www.oneamyloidosisvoice.com/news-meeting/isa-symposium-amyloidosis/ |
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)