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An early achievement of CHR is crucial in amyloidosis. We retrospectively evaluated the relationship between dFLC (the difference between free light chain) reduction by Day 7 in Cycle 1 (C1D7) and CHR, organ response, and survival in 48 newly diagnosed AL amyloidosis patients receiving daratumumab, bortezomib, and dexamethasone. The CHR rate within six months was 66.7%. Using Receiver Operating Characteristic Curve curve analysis, we predicted CHR based on a dFLC reduction in C1D7 (67.0% change, optimal sensitivity 87.5%, specificity 81.3%). We introduce the novel concept of \u201crapid hematologic dFLC response\u201d, defined as a reduction in dFLC levels\u2009\u2265\u200967% in C1D7. The CHR rate in rapid responders\u2019 groups was higher than that in slow responders\u2019 group (90.3% vs. 23.5%, <jats:italic>P<\/jats:italic>&lt;0.01). After a median follow-up of 19 months (range: 0.3\u201357), the renal response rate in rapid responders was higher than that in slow responders (72.0% vs. 27.5%, <jats:italic>P<\/jats:italic>\u2009=\u20090.025). The median major organ deterioration event-free survival in the rapid responders\u2019 group (not reached) was significantly superior to that in the slow responders\u2019 group (19\u00a0m, 95% CI: 1.79\u201323.14\u00a0m, <jats:italic>P<\/jats:italic>\u2009=\u20090.048). In conclusion, early dFLC reduction in C1D7 indicates a high possibility of CHR and organ response and may allow for early modification of therapy in selected patients.<\/jats:p>","DOI":"10.1007\/s00277-024-06077-0","type":"journal-article","created":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T01:09:33Z","timestamp":1731373773000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Early dFLC response by C1D7 predicts complete hematologic response in systemic AL amyloidosis"],"prefix":"10.1007","author":[{"given":"Yang","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingyi","family":"Bi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuelin","family":"Dou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan","family":"Peng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Wen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanqiu","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaojun","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,11,12]]},"reference":[{"issue":"2","key":"6077_CR1","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1002\/ajh.27177","volume":"99","author":"MA Gertz","year":"2024","unstructured":"Gertz MA (2024) Immunoglobulin light chain amyloidosis: 2024 update on diagnosis, prognosis, and treatment. 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