Daratumumab in light chain deposition disease: rapid and profound hematologic response preserves kidney function

Light chain deposition disease (LCDD) is a monoclonal gammopathy of clinical significance1 that is characterized by the formation of unstructured tissue deposits of the monoclonal immunoglobulin light chain. The kidney is involved in almost all patients. Renal involvement results in proteinuria, hypertension, and microhematuria. The clonal plasma cell infiltrate is usually small (<10% in ∼85% of patients).2 In the absence of an effective therapy, the disease progresses to chronic kidney failure, eventually requiring renal replacement therapy.3-6