Profound dFLC decrease after one cycle predicts superior outcome in patients with AL amyloidosis

The relationship between an early decrease in the difference between involved and uninvolved free light chains (dFLC) and clinical outcomes in AL amyloidosis is significant. We conducted a multicenter study (<i>n</i> = 86, baseline dFLC ≥ 50 mg/L) in which all patients received frontline daratumumab-bortezomib therapy. ROC analysis identified a dFLC reduction after one cycle (87% reduction, AUC = 0.82) as predictive of complete hematologic response (CHR). Patients achieving >87% dFLC or a very good partial response after one cycle were classified as optimal responders (O-HR), while those who did not were classified as suboptimal response (S-HR). The O-HR group had higher rate of CHR (90.5% vs. 43.5%, <i>p</i> < 0.001), cardiac response (68.9% vs. 36.8%, <i>p</i> = 0.017), and renal response (76.6% vs. 50.0%, <i>p</i> = 0.045) than the S-HR group. Profound dFLC decrease after one cycle suggests high CHR and organ response likelihood, supporting early treatment modification.

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Publication Details

Journal
Leukemia & lymphoma/Leukemia and lymphoma
Published
2025-10-15
DOI
https://doi.org/10.1080/10428194.2025.2571200
Citations
1
Primary Topic
Amyloidosis: Diagnosis, Treatment, Outcomes
Type
article
Field-Weighted Citation Impact
0.81
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article

Profound dFLC decrease after one cycle predicts superior outcome in patients with AL amyloidosis

Jin Lu, Yanqiu Zhao, Nan Peng, Yanyan Zhang et al.
1 citations
Leukemia & lymphoma/Leukemia and lymphoma
Amyloidosis: Diagnosis, Treatment, Outcomes
0.81
article

Profound dFLC decrease after one cycle predicts superior outcome in patients with AL amyloidosis

Jin Lu, Yanqiu Zhao, Nan Peng, Yanyan Zhang, Liru Wang, Wanjing Zhang, Yanqing Zhang, Yanping Cao, Jianping Bi, Yang Liu, Xuelin Dou, Wen Lei
article en
1 citations

Abstract

The relationship between an early decrease in the difference between involved and uninvolved free light chains (dFLC) and clinical outcomes in AL amyloidosis is significant. We conducted a multicenter study (<i>n</i> = 86, baseline dFLC ≥ 50 mg/L) in which all patients received frontline daratumumab-bortezomib therapy. ROC analysis identified a dFLC reduction after one cycle (87% reduction, AUC = 0.82) as predictive of complete hematologic response (CHR). Patients achieving >87% dFLC or a very good partial response after one cycle were classified as optimal responders (O-HR), while those who did not were classified as suboptimal response (S-HR). The O-HR group had higher rate of CHR (90.5% vs. 43.5%, <i>p</i> < 0.001), cardiac response (68.9% vs. 36.8%, <i>p</i> = 0.017), and renal response (76.6% vs. 50.0%, <i>p</i> = 0.045) than the S-HR group. Profound dFLC decrease after one cycle suggests high CHR and organ response likelihood, supporting early treatment modification.

Leukemia & lymphoma/Leukemia and lymphomaVol. 67(1)
Handan College (CN), Beijing Institute of Technology (CN), Harbin Medical University (CN), Capital Medical University (CN), Peking University (CN), Peking University People's Hospital (CN), University of Hong Kong - Shenzhen Hospital (CN), Southern Medical University Shenzhen Hospital (CN), First Affiliated Hospital of Harbin Medical University (CN)
Openalex Percentile: Top 22%
Amyloidosis: Diagnosis, Treatment, Outcomes
0.81
DOIOpen Access PDFOpenAlex
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