Daratumumab for relapsed or refractory AL amyloidosis with high plasma cell burden
| العنوان: | Daratumumab for relapsed or refractory AL amyloidosis with high plasma cell burden |
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| المؤلفون: | Davide Rossi, Rahel Schwotzer, Raphael Heimgartner, Andreas J. Flammer, Georg Stussi, Bernhard Gerber, Guido Ghilardi, Erika Lerch, Christine Waibel, Harald Seeger, Clemens Caspar, Stefanie Pederiva, Thomas Fehr, Elena Bianchi, Markus G. Manz, Sofie Brouwers |
| المساهمون: | Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Clinical Pharmacy, Experimental Pharmacology, University of Zurich, Schwotzer, Rahel |
| المصدر: | Hematological Oncology. 37:595-600 |
| بيانات النشر: | Wiley, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Male, Cancer Research, 2720 Hematology, Immunoglobulin Light-chain Amyloidosis/diagnosis, Severity of Illness Index, Gastroenterology, Antineoplastic Agents, Immunological, 0302 clinical medicine, Bone Marrow, Recurrence, Immunoglobulin Light-chain Amyloidosis, 10035 Clinic for Nephrology, 1306 Cancer Research, Bortezomib, Amyloidosis, Antibodies, Monoclonal, Hematology, General Medicine, Middle Aged, Treatment Outcome, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Retreatment, 10209 Clinic for Cardiology, 2730 Oncology, Female, medicine.drug, Adult, medicine.medical_specialty, Plasma Cells, Infections/etiology, 610 Medicine & health, Infections, Antibodies, Monoclonal/administration & dosage, 03 medical and health sciences, Antineoplastic Agents, Immunological/administration & dosage, Refractory, Internal medicine, medicine, AL amyloidosis, Humans, Lymphocyte Count, Adverse effect, Aged, Lenalidomide, Bone Marrow/metabolism, business.industry, Daratumumab, medicine.disease, Drug Resistance, Neoplasm, 10032 Clinic for Oncology and Hematology, Plasma Cells/pathology, Bone marrow, business, 030215 immunology |
| الوصف: | Daratumumab, an anti-CD38 antibody, is effective in AL amyloidosis with low tumor burden. Data of daratumumab treatment in patients with AL amyloidosis but high tumor burden (≥10% bone marrow plasma cells) are limited. We report retrospective data of 10 consecutive patients with high tumor burden treated with daratumumab for relapsed/refractory AL amyloidosis. The median age at diagnosis was 62.3 years; all patients had cardiac involvement, and six (60%) patients had renal involvement. Median bone marrow plasma cell infiltration was 15% (range 10%-40%), and the median difference between involved and noninvolved free light-chains (dFLC) was 446 mg/L (range 102-1392 mg/L). Patients had a median of three prior lines of therapy, including bortezomib in all patients and lenalidomide in seven (70%) patients. The median time to first hematological response was 14 days (range 7-28 days), and the median time to best hematological response was 64 days (range 7-301 days). The hematological overall response was 90%, with high-quality response (≥ very good partial remission [VGPR]) in 70% of the patients. Fifty percent of the patients had a cardiac response after a median of 3.8 months (range 0.7-9.1). Infusion-related adverse events ≤ grade 2 occurred in seven (70%) patients and grade 3 adverse events in one patient. After a median follow-up time of 10 months, eight (80%) patients continued to receive daratumumab. We conclude that daratumumab is a very effective and safe treatment option in AL patients with relapsed/refractory disease and high disease burden at diagnosis. Daratumumab leads to rapid disease control and improvement of organ function. |
| تدمد: | 1099-1069 0278-0232 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::afce2e4f761edbd1d13b6d39b85360dfTest https://doi.org/10.1002/hon.2677Test |
| حقوق: | RESTRICTED |
| رقم الانضمام: | edsair.doi.dedup.....afce2e4f761edbd1d13b6d39b85360df |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 10991069 02780232 |
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