**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Marco Basset; Amyloidosis Research and Treatment Center, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo and Department of Molecular Medicine, University of Pavia, Pavia, Italy

**Main Body of the Abstract**
We showed that autologous stem cell transplant (ASCT) can be deferred in patients with AL amyloidosis who achieve satisfactory response (i.e., partial response or very good partial response with organ response, or complete response) after  cyclophosphamide/bortezomib/dexamethasone (CyBorD). We expanded enrollment and extended follow-up. Patients diagnosed between 2009 and 2021 eligible for ASCT according to ISA guidelines received CyBorD and did not proceed to transplant in case of satisfactory response. One-hundred ninety-five patients were included. Eighty-two (42%) achieved a satisfactory response after CyBorD. Of 113 patients with unsatisfactory response, 77 (68%) underwent ASCT and 41 (32%) received rescue therapy (daratumumab in 19 [46%], IMiDS in 14 [37%] and MDex in 7 [17%]) due to loss of eligibility/refusal. Response rates are reported in Figure 1A. After a median follow-up of 6.3 years, 62 patients (32%) died (1 within 100 days). There was no difference in survival (80% vs. 84% at 5 years, P=0.538) and median time to next treatment or death (median 60 vs. 62 months; P=0.803) between patients who received CyBorD alone or followed by ASCT. Standard IMiDs or MDex rescue was associated with poorer survival (42% at 5 years, P<0.001); whereas, daratumumab-based rescue granted similar survival to that observed in responders to CyBorD/ASCT or CyBorD alone (63% at 5 years, P=0.287; Figure 1B). This sequential, response-driven approach to treat ASCT-eligible patients is safe and effective. Daratumumab-based rescue seems to overcome the poor outcome of non-responders. The introduction of daratumumab in induction further reduces the need to proceed  to ASCT.



**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Marco Basset; _Amyloidosis Research and Treatment Center, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo and Department of Molecular Medicine, University of Pavia, Pavia, Italy_

**Main Body of the Abstract**
We showed that autologous stem cell transplant (ASCT) can be deferred in patients with AL amyloidosis who achieve satisfactory response (i.e., partial response or very good partial response with organ response, or complete response) after  cyclophosphamide/bortezomib/dexamethasone (CyBorD). We expanded enrollment and extended follow-up. Patients diagnosed between 2009 and 2021 eligible for ASCT according to ISA guidelines received CyBorD and did not proceed to transplant in case of satisfactory response. One-hundred ninety-five patients were included. Eighty-two (42%) achieved a satisfactory response after CyBorD. Of 113 patients with unsatisfactory response, 77 (68%) underwent ASCT and 41 (32%) received rescue therapy (daratumumab in 19 [46%], IMiDS in 14 [37%] and MDex in 7 [17%]) due to loss of eligibility/refusal. Response rates are reported in Figure 1A. After a median follow-up of 6.3 years, 62 patients (32%) died (1 within 100 days). There was no difference in survival (80% vs. 84% at 5 years, P=0.538) and median time to next treatment or death (median 60 vs. 62 months; P=0.803) between patients who received CyBorD alone or followed by ASCT. Standard IMiDs or MDex rescue was associated with poorer survival (42% at 5 years, P<0.001); whereas, daratumumab-based rescue granted similar survival to that observed in responders to CyBorD/ASCT or CyBorD alone (63% at 5 years, P=0.287; Figure 1B). This sequential, response-driven approach to treat ASCT-eligible patients is safe and effective. Daratumumab-based rescue seems to overcome the poor outcome of non-responders. The introduction of daratumumab in induction further reduces the need to proceed  to ASCT.



Long term outcome of a sequential response-driven bortezomib-based therapy followed by autologous stem cell transplant in AL amyloidosis PA166 (#485)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.