Do you continue daratumumab beyond 24 months in first line treatment of amyloidosis?

This is an important and common clinical question, and one for which prospective data are currently limited. For background, the ANDROMEDA clinical trial (Kastritis et al., PMID 34192431) demonstrated that the addition of daratumumab to cyclophosphamide, bortezomib, and dexamethasone (CyBorD) signif...

While ANDROMEDA only goes to 24 months, I usually go beyond that, especially in these scenarios:

• Patient has smoldering myeloma (instead of MGUS)
• High-risk mutations: t(4:14). Rarely do we see TP53
• Persistent MRD+. I do repeat BMs and MRD assessment at least first 2 years (thankfully, we have not ha...

Well stated, Drs. @Dr. First Last and @Dr. First Last. As alluded to, there is a ton of nuance here.

In terms of disease bulk at diagnosis— plasma cell burden in the marrow— I'm not convinced this should dictate treatment duration necessarily. Our approach is more dictated by response after completi...