**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.**
Binoy Yohannan
Mayo Clinic
200 First St. SW
Rochester, MN 55905

**Main Body of the Abstract**
Background: AL amyloidosis is a potentially fatal disease. In the ANDROMEDA trial, the addition of daratumumab to CyBorD backbone significantly improved hematological response (HR), organ response, and event-free survival (EFS).  We performed a real-world study to investigate the efficacy of the addition of daratumumab to first-line therapy.
Methods: Single-center retrospective study of consecutive newly diagnosed AL amyloidosis patients seen between 2018 and 2022. Patients who received frontline daratumumab (with or without bortezomib) were compared to those treated with bortezomib-based therapy. For EFS analysis, an event was defined as death, hematological progression, end-stage cardiac or renal failure, or need for subsequent anti-plasma cell therapy in the absence of hematological progression.
Results:  333 consecutive patients were evaluated (daratumumab group=133, bortezomib group=200). The overall HR, complete response, and ≥very good partial response at 2 months were better with daratumumab compared to bortezomib (91.3% vs 80.5%, P=0.01; 15.9% vs 5.8%, P=0.009; 62.7% vs 40.2 %, P =0.0002, respectively). Overall cardiac response rate at 6 and 12 months was better in the daratumumab group (54% vs 32.1%, P=0.01; 80% vs 56%, P=0.009 respectively). There was no difference in the renal response at 6 and 12 months (51.1% vs 42.9%, P=0.43; 53.3% vs 69.6%, P=0.10 respectively). Daratumumab reduced the 3-month early death rate (6.0% vs 13%, P=0.04).  The two-year EFS and overall survival (OS) were significantly higher in the daratumumab group (Figure).
Conclusions: The addition of daratumumab to frontline therapy significantly improved HR and cardiac response, reduced early death rate, and prolonged EFS and OS.



**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.**
Binoy Yohannan
Mayo Clinic
200 First St. SW
Rochester, MN 55905

**Main Body of the Abstract**
**Background:** AL amyloidosis is a potentially fatal disease. In the ANDROMEDA trial, the addition of daratumumab to CyBorD backbone significantly improved hematological response (HR), organ response, and event-free survival (EFS).  We performed a real-world study to investigate the efficacy of the addition of daratumumab to first-line therapy.
**Methods**: Single-center retrospective study of consecutive newly diagnosed AL amyloidosis patients seen between 2018 and 2022. Patients who received frontline daratumumab (with or without bortezomib) were compared to those treated with bortezomib-based therapy. For EFS analysis, an event was defined as death, hematological progression, end-stage cardiac or renal failure, or need for subsequent anti-plasma cell therapy in the absence of hematological progression.
**Results:**  333 consecutive patients were evaluated (daratumumab group=133, bortezomib group=200). The overall HR, complete response, and ≥very good partial response at 2 months were better with daratumumab compared to bortezomib (91.3% vs 80.5%, P=0.01; 15.9% vs 5.8%, P=0.009; 62.7% vs 40.2 %, P =0.0002, respectively). Overall cardiac response rate at 6 and 12 months was better in the daratumumab group (54% vs 32.1%, P=0.01; 80% vs 56%, P=0.009 respectively). There was no difference in the renal response at 6 and 12 months (51.1% vs 42.9%, P=0.43; 53.3% vs 69.6%, P=0.10 respectively). Daratumumab reduced the 3-month early death rate (6.0% vs 13%, P=0.04).  The two-year EFS and overall survival (OS) were significantly higher in the daratumumab group (Figure).
**Conclusions:** The addition of daratumumab to frontline therapy significantly improved HR and cardiac response, reduced early death rate, and prolonged EFS and OS.



Daratumumab-Based Front-line Therapy Improves Treatment Response and Survival in Patients with Immunoglobulin Light chain (AL) Amyloidosis: The Mayo Clinic Experience OA13 (#529)

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.