Theodorakakou Foteini, Fotiou Despina, Spiliopoulou Vasiliki, Roussou Maria, Malandrakis Panagiotis, Ntanasis-Stathopoulos Ioannis, Migkou Magdalini, Eleutherakis-Papaiakovou Evangelos, Kanellias Nikolaos, Papanikolaou Asimina, Gavriatopoulou Maria, Terpos Evangelos, Dimopoulos Meletios A, Kastritis Efstathios
Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
Department of Haemopathology, "Evangelismos" Hospital, Athens, Greece.
Br J Haematol. 2023 Nov;203(3):411-415. doi: 10.1111/bjh.19042. Epub 2023 Aug 14.
As daratumumab use in AL amyloidosis increases, more patients will either relapse after or become refractory to daratumumab. We present the outcome of 33 patients with AL who failed on daratumumab (due to haematological relapse in 21 [64%] patients and inadequate haematological response in 12 [36%]) and received further treatment. Overall response rate in the post-daratumumab failure treatment was 55% (CR/VGPR: 14 [42%] and PR: 3 [9%] patients). Patients retreated with daratumumab and patients harbouring +1q21 had lower rates of response. Treatment of patients with AL who fail daratumumab therapy is feasible when non-cross-resistant drugs or other targeted therapies are available.
随着达雷妥尤单抗在 AL 淀粉样变性中的应用增加,更多患者将在使用达雷妥尤单抗后复发或对其产生耐药。我们报告了 33 例使用达雷妥尤单抗治疗失败(21 例[64%]因血液学复发,12 例[36%]因血液学反应不佳)并接受进一步治疗的 AL 患者的治疗结果。达雷妥尤单抗治疗失败后的总体缓解率为 55%(CR/VGPR:14 例[42%],PR:3 例[9%])。再次使用达雷妥尤单抗治疗的患者和携带 +1q21 的患者缓解率较低。当有非交叉耐药药物或其他靶向治疗可用时,治疗达雷妥尤单抗治疗失败的 AL 患者是可行的。