Case Report: Treatment of light‐chain amyloidosis with daratumumab monotherapy in two patients

Immunoglobulin light‐chain amyloidosis (AL) affects multiple organs, most prominently the kidney and the heart. Renal and cardiac impairment are both associated with poor prognosis and most patients die as a consequence of renal or cardiac failure. Monoclonal antibodies such as daratumumab (human IgG1 anti‐CD38) and elotuzumab (anti‐SLAMF7) have shown promising efficacy for the treatment of relapsed and refractory multiple myeloma. In this case report we show 2 patients with severe AL, one with severe heart failure and one with heart and renal failure, undergoing treatment with daratumumab. Both patients showed a rapid decrease in FLC in response to daratumumab infusions, with few associated adverse events. Using therapeutic CD38 antibodies as a front‐line treatment for AL could induce rapid responses while maintaining a tolerable safety profile in these ultra‐fragile patients.