{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T02:33:40Z","timestamp":1777948420454,"version":"3.51.4"},"reference-count":44,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HemaSphere"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Rapid and profound reduction of free light chains (FLCs) improves outcomes in AL amyloidosis; however, early FLC kinetics with daratumumab\u2010based frontline therapy remain undefined. We retrospectively analyzed 315 patients treated with daratumumab\u2013bortezomib\u2013cyclophosphamide\u2013dexamethasone (Dara\u2013VCd) or Dara\u2013Vd at eight centers. Involved FLC (iFLC), the difference between iFLC and uninvolved FLC (dFLC), and hematologic response (\u2265very good partial response [VGPR]) were assessed at baseline and at 1, 3, and 6 months, and correlated with light chain isotype, disease burden (bone\u2010marrow plasma\u2010cell percentage [%BMPC], baseline dFLC), and cytogenetics. Hematological \u2265VGPR increased from 49.8% at 1 month to 66.0% at 3 months. The kappa isotype showed slower responses, with higher iFLC\/dFLC and lower \u2265VGPR at each time point compared to lambda. Higher %BMPC or baseline dFLC predicted persistently elevated iFLC\/dFLC and reduced \u2265VGPR. The t(11;14) translocation was associated with lower baseline FLC but similar subsequent kinetics. BMPC\u2009&lt;\u200910% and dFLC &lt; 18\u2009mg\/dL independently predicted early \u2265VGPR (in \u22641 month). Early \u2265VGPR conferred superior hematologic event\u2010free survival (heme\u2010EFS) and overall survival (OS) versus later responders (P\u2009&lt;\u20090.001). At a 3\u2010month landmark, achieving dFLC &lt; 1\u2009mg\/dL further stratified prognosis, conferring longer heme\u2010EFS and OS (P\u2009&lt;\u20090.01). Frontline Dara\u2010based therapy elicits rapid, deep responses in AL amyloidosis; early \u2265VGPR (within 1 month) and dFLC &lt; 1\u2009mg\/dL by 3 months predict durable EFS and OS, whereas higher baseline disease burden delays hematologic response.<\/jats:p>","DOI":"10.1002\/hem3.70276","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T03:02:18Z","timestamp":1766977338000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Kinetics of hematologic response in AL amyloidosis: Insights from clinical and cytogenetic subgroup analysis in the daratumumab era"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0243-4040","authenticated-orcid":false,"given":"Abdul\u2010Hamid","family":"Bazarbachi","sequence":"first","affiliation":[{"name":"Division of Hematology\/Oncology Columbia University Irving Medical Center New York New York United 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