Predictive factors of outcomes in patients with AL amyloidosis treated with daratumumab.
Adult
Aged
Aged, 80 and over
Antibodies, Monoclonal
/ therapeutic use
Antineoplastic Agents, Immunological
/ therapeutic use
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Female
Humans
Immunoglobulin Light-chain Amyloidosis
/ diagnosis
Male
Middle Aged
Prognosis
Progression-Free Survival
Prospective Studies
Survival Analysis
Treatment Outcome
Journal
American journal of hematology
ISSN: 1096-8652
Titre abrégé: Am J Hematol
Pays: United States
ID NLM: 7610369
Informations de publication
Date de publication:
01 01 2022
01 01 2022
Historique:
revised:
25
10
2021
received:
22
10
2021
accepted:
28
10
2021
pubmed:
6
11
2021
medline:
15
2
2022
entrez:
5
11
2021
Statut:
ppublish
Résumé
Daratumumab as a single agent (sDARA) or in combination with chemotherapies (cDARA) leads to impressive hematologic and organ responses in AL amyloidosis. However, predictive factors associated with outcomes, and optimal duration of therapy remain unclear. We analyzed 107 patients with AL amyloidosis treated with daratumumab between 2017 and 2020. The median overall survival (OS) was not reached while the median major organ deterioration progression free survival (MOD-PFS) was 36 months in the sDARA cohort and not reached in the cDARA cohort, respectively. Hematologic response > VGPR was achieved in 81% of patients receiving sDARA and 86% of patients treated with cDARA. Several predictive factors were identified on a univariate analysis, including NTproBNP >8500 pg/mL but only achievement of at least VGPR and presence of 1q21 gain were independently associated with MOD-PFS and OS on a multivariate analysis. Finally, patients receiving > 12 cycles had significantly longer MOD-PFS (30 vs.13 months; (p = .0018) and OS (NR vs. 15 months; p < .0001). NTproBNP > 8500 pg/mL, presence of 1q21 gain and shorter duration of therapy (≤ 12 cycles) are strong negative predictive factors for outcomes with daratumumab therapy in AL amyloidosis.
Substances chimiques
Antibodies, Monoclonal
0
Antineoplastic Agents, Immunological
0
daratumumab
4Z63YK6E0E
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
79-89Informations de copyright
© 2021 Wiley Periodicals LLC.
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