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Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Posted: Thursday, November 3, 2022
Daratumumab-based chemoimmunotherapy regimens may result in high response rates for patients with multiple myeloma or AL amyloidosis who have advanced chronic kidney disease, according to findings presented at the 2022 International Myeloma Society (IMS) Annual Meeting and Exposition (Abstract P-013). A hematologic response was associated with improvement in renal function, particularly in patients who had acute renal failure because of underlying multiple myeloma or AL amyloidosis, concluded Chakra Chaulagain, MD, of the Maroone Cancer Center, Cleveland Clinic Florida, Weston, Florida, and colleagues.
In this single-center retrospective analysis, the authors collected data from 12 patients with multiple myeloma and 3 patients with AL amyloidosis who had been treated with daratumumab-based regimens during stage IV chronic kidney disease (7 patients) or end-stage renal disease (8 patients). Fewer than half of the patients (40%) were newly diagnosed with multiple myeloma and presented with acute renal failure, whereas 60% had relapsed or refractory disease at the time of initiation of daratumumab-based therapy. All patients received daratumumab with either a proteasome inhibitor or an immunomodulatory drug.
The investigators found that 54% of the patients had a complete hematologic response, 20% a very good partial response, 13% a partial response, 6.5% had progressive disease, and 6.5% had stable disease. Treatment with daratumumab was reported to be well tolerated, with no cases of tumor-lysis syndrome, serious infections, critical cytopenia, or significant infusion reaction. Three patients died during therapy: two from cardiac conditions and one from progressive myeloma.
Daratumumab-based therapy was also associated with an improvement in renal function, leading to the prevention of end-stage renal disease and dialysis in all seven patients who presented with acute-on-chronic renal failure because of underlying multiple myeloma or AL amyloidosis. However, the authors noted, daratumumab-based therapy did achieve dialysis independence in eight patients with established end-stage renal disease, despite antimyeloma responses in these patients.
Disclosure: Study authors’ disclosure information was not provided.
2022 IMS Annual Meeting and Exposition
