Successful treatment of Dara sc-CyBorD in a patient with AL amyloidosis and severe heart failure

Abstract

A 55-year-old woman was diagnosed with smoldering multiple myeloma (MM) in September 2021 and developed acute heart failure two months later. The patient was transferred to another hospital, where mitral valve replacement was performed for severe mitral regurgitation. Four months later, the patient developed acute renal failure and underwent continuous hemodiafiltration. She returned to our hospital for treatment of systemic amyloid light-chain (AL) amyloidosis, which later deteriorated to symptomatic MM. In April 2022, the patient underwent chemotherapy with subcutaneous daratumumab, cyclophosphamide, bortezomib, and dexamethasone (Dara sc-CyBorD). She achieved a very good partial response and the dobutamine treatment was discontinued at the end of the fifth course. The patient recovered from the severe heart failure. The patient was discharged and continued to receive outpatient chemotherapy. Our successful treatment of AL amyloidosis with severe heart failure using Dara sc-CyBorD is promising for patients ineligible for autologous hematopoietic stem cell transplantation, as a consolidation therapy due to organ damage.