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Multivariable Cox regression analysis revealed dFLC 180mg/l as an overall strong negative prognostic factor. Additionally, nephrotic range albuminuria with an albumin-to-creatinine-ratio (ACR) 220mg/mmol was a significantly adverse factor for hemEFS (Hazard ratio 2,1 and 3,1) with DD and DVD. Daratumumab salvage therapy produced good results and remission rates challenging any therapy in advanced AL. Outcome is adversely influenced by the activity of the underlying plasma cell dyscrasia (dFLC) and nephrotic range albuminuria (ACR