Daratumumab for Advanced Light Chain Amyloidosis

Summary and Comment |
August 28, 2016

Daratumumab for Advanced Light Chain Amyloidosis

  1. David Green, MD, PhD

Declines in light chain levels were achieved in heavily pretreated patients.

  1. David Green, MD, PhD

The prognosis for patients with advanced immunoglobulin light chain amyloidosis (AL) has improved with the use of several drugs that are approved for the treatment of multiple myeloma. Recently, daratumumab, a human anti–CD 38 monoclonal antibody, has been introduced for the management of relapsed or refractory multiple myeloma.

To determine whether daratumumab is safe and effective in advanced multisystem AL amyloidosis, investigators treated two patients that were in relapse after stem-cell transplant and combination chemotherapy with carfilzomib, cyclophosphamide, and dexamethasone. Daratumumab was given in eight weekly intravenous infusions in doses currently approved for myeloma therapy.

Clinical improvement occurred in both patients during daratumumab therapy. Elevated serum light chain levels rapidly fell into the normal range, and decreases in creatinine and troponin occurred. No serious adverse effects were encountered.

Comment

Daratumumab therapy induced striking declines in light chain levels as well as clinical and laboratory improvements in two heavily pretreated patients with extensive AL amyloidosis. The duration of this benefit and potential late toxicities are still unknown, but this brief report warrants further studies of daratumumab in these patients.

Editor Disclosures at Time of Publication

  • Disclosures for David Green, MD, PhD at time of publication Nothing to disclose

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