DRD vs. D-VCD in Newly Diagnosed AL Amyloidosis: A Retrospective Single-Center Study

Aim: This study evaluates hematologic responses in AL amyloidosis patients receiving first-line Daratumumab therapy with two regimens: D-VCD and DRD. DRD was preferred for patients with severe neurological involvement and those diagnosed before January 2023, when D-VCD was reimbursed in Romania. Methods: Between January 2021 and December 2023, 38 patients were treated with Daratumumab at Fundeni Clinical Institute, Romania: 23 with D-VCD and 15 with DRD. Results: The median age at diagnosis was 61.5 years. 65% of patients had ≥3 organ involvement. At 2 months, 88.2% of D-VCD patients reached ≥VGPR vs. 33.3% of DRD patients (p=0.010). In the DRD group, 55.5% and 75% reached ≥VGPR at 6 and 12 months, respectively. Six patients underwent ASCT, all in the D-VCD group, and have maintained ≥VGPR. No significant survival differences were noted between groups. Conclusions: DRD achieves significant hematologic responses at 6 and 12 months and may be a suitable firstline option for patients with severe neurological involvement.