Daratumumab is safe and induces a rapid hematological response in light-chain amyloidosis with severe cardiac impairment.

Eighteen patients received a dose of 20 mg at each daratumumab infusions, three patients received 10 mg and four patients did not receive dexamethasone because of dexamethasone induced cardiac failure. Systemic light-chain (AL) amyloidosis is a plasma cell disorder characterized by extracellular deposition of monoclonal immunoglobulin light chains leading to organ dysfunction. We assessed the efficacy of daratumumab in such AL patients with severe cardiac involvement by performing a single-center retrospective study that included consecutive patients with Mayo Clinic stage III AL treated with daratumumab from May 2017 to August 2019. However, patients with severe cardiac amyloidosis involvement, defined as stage IIIb by the Mayo classification with European modification, have been excluded from these studies and little data on daratumumab use are available for patients with severe cardiac involvement. [Extracted from the article]