Abstract: FR-PO0844
Real-World Outcomes of Daratumumab-Based Therapy in AL Amyloidosis with Kidney Involvement: Predictors of Mortality, Kidney Disease Progression, and Survival
Session Information
- Glomerular Diseases: Practice and New Concepts Shaping Modern Care
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Tatis, Efrain, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain
- Ramos, Natalia, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain
- Gironella, Mercedes, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain
- Fernandez, Inmaculada, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain
- Martinez Valle, Fernando, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain
- Patricio-Liébana, Marc, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain
- Bermejo Garcia, Sheila, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain
- Agraz Pamplona, Irene, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain
- López-Martínez, Marina, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain
- León Román, Juan Carlos, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain
- Soler Romeo, Maria Jose, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain
Background
Daratumumab has improved outcomes in AL amyloidosis, but real-world data in patients with renal involvement are limited. We evaluated the effectiveness and safety of daratumumab-based regimens in AL amyloidosis with renal involvement.
Methods
Retrospective single-center study including 65 patients with AL amyloidosis and renal involvement treated with daratumumab-based (n=21) or non-daratumumab regimens (n=44). Outcomes included overall survival, ESKD, and the composite of death or ESKD.
Results
Daratumumab-treated patients achieved higher hematologic complete response (CR) (38.1% vs 11.9%, p=0.037), very-good partial response (VGPR) or better (81.0% vs 28.6%, p<0.001), renal CR (38.1% vs 9.5%, p=0.014), and renal VGPR or better (61.9% vs 19.0%, p=0.002), with lower mortality (28.6% vs 81.0%, p<0.001). ECOG ≥2 and cardiac involvement independently predicted mortality, while Palladini renal renal stage predicted renal progression and ESKD. Daratumumab was independently associated with lower mortality and lower risk of death or ESKD.
Conclusion
In this real-world cohort, daratumumab-based regimens were associated with deeper hematologic and renal responses and improved survival in AL amyloidosis with renal involvement, supporting their central role in current treatment strategies.
Baseline characteristics according to daratumumab treatment
| Variable | Total (n=65) | Daratumumab (n=21) | No Daratumumab (n=42) | p-value |
| Age (years), mean ± SD | 68.6 ± 14.7 | 69.4 ± 8.5 | 67.7 ± 17.1 | 0.597 |
| Male sex, n (%) | 34 (52.3) | 10 (47.6) | 22 (52.4) | 0.929 |
| ECOG ≥2, n (%) | 35 (54.7) | 12 (57.1) | 23 (54.8) | 0.690 |
| Cardiac involvement, n (%) | 40 (61.5) | 17 (81.0) | 22 (52.4) | 0.032 |
| Serum creatinine (mg/dL), median [IQR] | 1.01 [0.77–1.47] | 0.98 [0.77–1.67] | 0.98 [0.76–1.47] | 0.771 |
| eGFR (mL/min/1.73m2), median [IQR] | 61.5 [40.8–88.0] | 54 [36–86] | 73 [45–88] | 0.588 |
| 24-h proteinuria (g/day), median [IQR] | 4.19 [3.27–7.22] | 4.28 [1.67–6.5] | 4.6 [6.62–7.25] | 0.759 |
| dFLC (mg/L), median [IQR] | 177.7 [78.9–536.4] | 263.1 [71.2–606.2] | 132.2 [84.8–434.0] | 0.361 |
| Lambda light chain, n (%) | 47 (72.3) | 16 (76.2) | 30 (71.4) | 0.920 |