Daratumumab Monotherapy versus Bortezomib-Based Regimens in frail patients with Biopsy-Proven Renal AL Amyloidosis

Clicks: 1
ID: 314240
2026
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal

Ranked #77 of 98 articles by views in nephrology dialysis transplantation

Most read Least read

Bar heights use a square-root scale.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Abstract
BACKGROUND: Bortezomib-based regimens have long represented the standard option for systemic AL amyloidosis, whereas daratumumab has recently emerged as a promising alternative. We compared two consecutive single-center cohorts of frail, non-transplant-eligible patients treated with either bortezomib-based therapy or daratumumab monotherapy, assessing clinical and renal outcomes. METHODS: Thirty-one patients with renal AL amyloidosis were included: 17 received bortezomib-based regimens (historical cohort) and 14 received daratumumab monotherapy (prospective cohort). All had biopsy-confirmed renal amyloid deposition and were transplan-ineligible. Hematologic and organ responses followed International Society of Amyloidosis criteria. RESULTS: Baseline characteristics were similar between cohorts. Hematologic response rates were 57.1% with bortezomib versus 92.8% with daratumumab (p = 0.03), with complete responses in 28.6% and 57.1%, respectively. Renal response occurred in 35% of bortezomib-treated patients versus 71.4% with daratumumab (p = 0.04). Proteinuria declined by 76% in bortezomib responders and 72% in daratumumab responders, with stable creatinine in both groups. Among patients achieving dual hematologic and renal responses, 12-month survival was 100% in the daratumumab cohort versus 71% in the historical group. At last follow-up, renal survival was 67% versus 86%, and overall survival 47% versus 79% (p = 0.08). Major infections occurred in 18% and 14%, respectively. Repeat biopsies showed stabilization or regression of amyloid in 62% of daratumumab-treated versus 20% of historical cases. CONCLUSIONS: In frail, ASCT-ineligible patients with biopsy-proven renal AL amyloidosis, daratumumab monotherapy yielded higher hematologic and renal response rates compared with bortezomib-based regimens. These findings support early anti-CD38 therapy as a potential strategy to improve renal preservation and survival, warranting confirmation in multicenter trials.
Reference Key
openalex_W7161858523 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Roccatello Dario, Sciascia Savino, Antonella Barreca, Rabajoli Gianluca, Del Vecchio Giulio, Rossi Daniela, Rubini Elena, Fenoglio Roberta
Journal nephrology dialysis transplantation
Year 2026
DOI
10.1093/ndt/gfag117
URL
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

No comments yet. Be the first to comment on this article.