Table 1.
Summary of selected studies investigating the efficacy of different therapies in AL. In each study, organ responses were observed in only a subset of patients in whom a hematological response (HR) was observed, although deeper HRs are associated with higher rates of organ response. Median overall survival is shown as a range for autologous stem cell transplant, from no hematologic response to a complete response. When median overall survival was not reached, the maximum follow-up time is shown.
| Study Reference | Treatment | Dates | Number of Patients | Patient Status | HR (CR) | Renal Response | Cardiac Response | Median Survival |
|---|---|---|---|---|---|---|---|---|
| Szalat et al. [36] | Autologous stem cell transplant | 2002–15 | 206 | ND | 69% (28%) | 54% | 62% | 3.7–14.5 yr |
| Kastritis et al. [41] | Melphalan + dexamethasone + bortezomib | 2011–16 | 53 | ND | 79% (23%) | 44% | 38% | >50 mo |
| Kastritis et al. (control) [41] | Melphalan + dexamethasone | 2011–16 | 56 | ND | 52% (20%) | 43% | 28% | 34 mo |
| ANDROMEDA [35] | CyBorD + Daratumumab | 2018–19 | 195 | ND | 91.8% (53.3%) | 53.0% | 41.5% | >20 mo |
| ANDROMEDA (control) [35] | CyBorD | 2018–19 | 193 | ND | 76.7% (18.1%) | 23.9% | 22.2% | >20 mo |
| Sanchorawala et al. [42] | Daratumumab + dexamethasone | 2017–19 | 22 | RR | 90% (41%) | 67% | 50% | >28 mo |
| Roussel et al. [43] | Daratumumab + dexamethasone | 2018–19 | 40 | RR | 70% (15%) | 31% | 29% | >36 mo |
| Milani et al. [40] | Pomalidomide + dexamethasone | 2009–18 | 153 | RR | 44% (3%) | 20% | 11% * | 29 mo |
| TOURMALINE-AL1 [44] | Ixazomib + dexamethasone | 2012–18 | 85 | RR | 53% (26%) | 28% | 18% | 34.8 mo |
CyBorD, cyclophosphamide, bortezomib and dexamethasone; ND, newly diagnosed; RR relapsed/refractory disease; CR, complete hematological response.
Pomalidomide can elevate the NT-proBMP biomarker used to evaluate cardiac response [40], so cardiac responses may be higher in patients treated with this agent.