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Abstract: PO2186

Daratumumab for Management of Bortezomib-Resistant Monoclonal Gammopathy of Renal Significance

Session Information

  • Onco-Nephrology - 1
    October 22, 2020 | Location: On-Demand
    Abstract Time: 10:00 AM - 12:00 PM

Category: Onco-Nephrology

  • 1500 Onco-Nephrology

Authors

  • Almaani, Salem, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
  • Parikh, Samir V., The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
  • Bumma, Naresh, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
  • Sharma, Nidhi, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
  • Efebera, Yvonne A., The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
  • Ayoub, Isabelle, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
Background

The management of monoclonal gammopathy of renal significance (MGRS) is challenging. In our center, MGRS patients are initially treated with a bortezomib-based regimen. Patients who do not respond have very limited therapeutic options. Daratumumab is an anti-CD38 monoclonal antibody that is being increasingly used in patients with multiple myeloma with a favorable adverse effect profile, and represents a potential therapeutic option for patients with MGRS.

Methods

Retrospective review of the use of daratumumab in management of patients with bortezomib-resistant MGRS.

Results

Five patients were treated with daratumamab after receiving a variety of immunomodulatory therapies (Table 1). All received bortezomib with no response. One patient had a dramatic improvement in proteinuria with a stable renal function. One patient had resolution of glomerular monoclonal protein deposits but had persistent proteinuria due to significant damage to the glomerular basement membrane. One patient suffered from an acute kidney injury due to acute tubular necrosis (noted on biopsy) and became dialysis dependent. Two patients were started on daratumumab recently and had limited follow up, however both demonstrated a reduction in proteinuria. Daratumumab was well-tolerated and no patients required hospitalization due to adverse effects.

Conclusion

Our experience in using daratumumab for management of bortezomib-resistant MGRS suggests good tolerability and short-term response rates.