Daratumumab demonstrated activity in the treatment of AL amyloidosis in two recently concluded phase II clinical trials in relapsed and refractory patients. Its role in upfront therapy is under evaluation in a phase III study. In this report we evaluated the safety and efficacy of 28-day cycles of daratumumab (single agent or combined with bortezomib or lenalidomide) in 72 previously treated patients with multiple myeloma and AL amyloidosis. Fifty (69%) were refractory to the last line of therapy. After eight infusions of daratumumab, 59 patients (82%) achieved a hematologic response, with 12 (16%) complete responses (CRs) and 30 (42%) very good partial responses (VGPRs). After 16 infusions, the quality of response improved with 22 patients (30%) achieving CR and 21 (29%) attaining VGPR. Cardiac response was observed in 11 of 37 evaluable patients (29%) and renal response in 23 of 38 patients (60%). Daratumumab is highly effective in heavily pretreated patients with relapsed/refractory AL amyloidosis and high bone marrow plasma cell burden. Renal responses, which are usually rare in this setting, were frequently observed.

High rate of profound clonal and renal responses with daratumumab treatment in heavily pre-treated patients with light chain (AL) amyloidosis and high bone marrow plasma cell infiltrate

Larocca A.;Oliva S.;
2020-01-01

Abstract

Daratumumab demonstrated activity in the treatment of AL amyloidosis in two recently concluded phase II clinical trials in relapsed and refractory patients. Its role in upfront therapy is under evaluation in a phase III study. In this report we evaluated the safety and efficacy of 28-day cycles of daratumumab (single agent or combined with bortezomib or lenalidomide) in 72 previously treated patients with multiple myeloma and AL amyloidosis. Fifty (69%) were refractory to the last line of therapy. After eight infusions of daratumumab, 59 patients (82%) achieved a hematologic response, with 12 (16%) complete responses (CRs) and 30 (42%) very good partial responses (VGPRs). After 16 infusions, the quality of response improved with 22 patients (30%) achieving CR and 21 (29%) attaining VGPR. Cardiac response was observed in 11 of 37 evaluable patients (29%) and renal response in 23 of 38 patients (60%). Daratumumab is highly effective in heavily pretreated patients with relapsed/refractory AL amyloidosis and high bone marrow plasma cell burden. Renal responses, which are usually rare in this setting, were frequently observed.
2020
95
8
900
905
https://onlinelibrary.wiley.com/doi/10.1002/ajh.25828
https://doi.org/10.1002/ajh.25828
Milani P.; Fazio F.; Basset M.; Berno T.; Larocca A.; Foli A.; Riva M.; Benigna F.; Oliva S.; Nuvolone M.; Rodigari L.; Petrucci M.T.; Merlini G.; Palladini G.
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Descrizione: [Restricted access - Published Version] Milani et al. Am J Hematol. 2020 Aug;95(8):900-905. doi: 10.1002/ajh.25828. Epub 2020 Apr 30. PMID: 32282971. Restricted access / Accesso riservato © 2020 Wiley Periodicals, Inc. Available at the following URL / disponibile all’URL: https://onlinelibrary.wiley.com/doi/10.1002/ajh.25828 | https://doi.org/10.1002/ajh.25828
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/1742170
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