AL patients don't dare go without dara

In this issue of Blood, 3 papers by the teams of Roussel et al, Sanchorawala et al, and Kimmich et al demonstrate high rates of efficacy and low rates of toxicity of single-agent daratumumab (dara) in patients with previously treated immunoglobulin light-chain (AL) amyloidosis.^1-3 These 3 reports include 2 small phase 2 prospective trials employing single-agent dara1,2 and a compilation of 168 consecutive patients treated with either daratumumab and dexamethasone (DD) or bortezomib and DD (DVD).³ Among previously treated AL patients, dara with low-intensity corticosteroid yielded partial hematologic response (PR) or better and very good partial response (VGPR) or better in 64% to 90% and in 56% to 86% of patients, respectively.^1-3 Progression-free survival (PFS) ranged from 12 to 28 months. Renal and cardiac responses were observed in 24% to 67% and 22% to 50% of patients, respectively. The vast majority of hematologic responses occurred after the first 4 doses of dara.