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Daratumumab monotherapy for relapsed AL amyloidosis: a single center retrospective analysis
Jun Ho Yi1, Sang Eun Yoon1, Seok Jin Kim1
1Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea.
Purpose:
Treatment of relapsed AL amyloidosis remains challenging as patients frequently suffer from severe organ dysfunctions. Daratumumab, a cornerstone drug in multiple myeloma and newly diagnosed AL amyloidosis, has also shown promise in relapsed AL amyloidosis.
Materials And Methods:
To assess the efficacy of daratumumab, we conducted a retrospective study of 40 patients who received daratumumab monotherapy in our prospective amyloidosis cohort.
Results:
The median age of the cohort was 67 years, and 31 patients were classified as stage III/IV by the Mayo 2012 guidelines and 32 patients as stage IIIa/IIIb by the European staging system. The overall hematologic and cardiac response rates were 72.5% and 42.4%, respectively. With median follow-up duration of 26.9 months, the estimated median progression-free survival was 21.9 months. Deep hematologic (p < 0.001) and cardiac response (p = 0.001) were associated with prolonged progression free survival. The duration of hematologic/cardiac responses were 26.2 months and 27.8 months, respectively. The median overall survival was 30.9 months. Treatment was well tolerated, as with 3 patients experiencing grade 3-4 hematologic adverse events and 8 experiencing grade 3-4 non-hematologic adverse events.
Discussion:
Our findings suggest that daratumumab monotherapy provides rapid and durable responses and is generally well tolerated in patients with relapsed AL amyloidosis.