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Kunvarjee B, Contreras Yametti GP, Blouin AG, Linder GE, Borge PD, Maryamchik E, Budhai A, Gupta GK, Scaradavou A, Spitzer BG, Curran KJ, Oved JH, Harris AC, Sharma A, Boelens JJ, Cancio MI. Donor-specific antibody desensitization with daratumumab prior to haematopoietic cell transplant for sickle cell disease: A case report. Br J Haematol 2024; 204:1540-1544. [PMID: 38212144 DOI: 10.1111/bjh.19289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/12/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024]
Affiliation(s)
- Binni Kunvarjee
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Gloria Paz Contreras Yametti
- Pediatric Bone Marrow Transplant and Cellular Therapies, MSK Kids, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Amanda G Blouin
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Grace E Linder
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - P Dayand Borge
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Elena Maryamchik
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Alexandra Budhai
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Gaurav K Gupta
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Andromachi Scaradavou
- Pediatric Bone Marrow Transplant and Cellular Therapies, MSK Kids, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Barbara G Spitzer
- Pediatric Bone Marrow Transplant and Cellular Therapies, MSK Kids, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kevin J Curran
- Pediatric Bone Marrow Transplant and Cellular Therapies, MSK Kids, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Joseph H Oved
- Pediatric Bone Marrow Transplant and Cellular Therapies, MSK Kids, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Andrew C Harris
- Pediatric Bone Marrow Transplant and Cellular Therapies, MSK Kids, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Jaap Jan Boelens
- Pediatric Bone Marrow Transplant and Cellular Therapies, MSK Kids, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Maria I Cancio
- Pediatric Bone Marrow Transplant and Cellular Therapies, MSK Kids, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Wu C, Manchen P, Edelman A, Husnain M, Katsanis E, Fuchs D, Stephens L, Khurana S. Refractory Pure Red Blood Cell Aplasia Secondary to Major ABO-Incompatible Allogeneic Stem Cell Transplantation Successfully Treated With Daratumumab. J Hematol 2023; 12:277-282. [PMID: 38188476 PMCID: PMC10769644 DOI: 10.14740/jh1195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/30/2023] [Indexed: 01/09/2024] Open
Abstract
Pure red cell aplasia (PRCA) is a rare hematologic phenomenon that is usually associated with inherited genetic mutations such as in Diamond-Blackfan anemia. However, due to the emergence of allogenic stem cell transplantation in the treatment of various malignant and non-malignant disorders, the incidence of PRCA has increased. PRCA following hematopoietic stem cell transplant (HSCT) is more commonly seen in the setting of a major ABO-incompatible transplant. Treatment of allo-HSCT induced PRCA can be initially supportive as it takes time for the bone marrow to fully recover. However, prolonged and/or failure of the bone marrow to recover, significantly increases patient's risk of iron overload in the setting of frequent transfusions. Iron deposition can potentially lead to severe life-threatening multiorgan involvement which can be fatal. Therefore, earlier recognition and intervention with immunomodulators in patients who undergo frequent transfusions can be beneficial to mitigate this risk. Here, we present a case with severe transfusion-dependent PRCA following major ABO-incompatible allo-HSCT successfully treated with daratumumab.
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Affiliation(s)
- Clinton Wu
- Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Pete Manchen
- Department of Pathology, University of Arizona, Tucson, AZ, USA
| | - Ariela Edelman
- Department of Pathology, University of Arizona, Tucson, AZ, USA
| | - Muhammad Husnain
- Department of Medicine, University of Arizona, Tucson, AZ, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
| | - Emmanuel Katsanis
- Department of Medicine, University of Arizona, Tucson, AZ, USA
- Department of Pathology, University of Arizona, Tucson, AZ, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA
- Department of Immunobiology, University of Arizona, Tucson, AZ, USA
| | - Deborah Fuchs
- Department of Pathology, University of Arizona, Tucson, AZ, USA
| | - Laura Stephens
- Department of Pathology, University of California San Diego Health, La Jolla, CA, USA
| | - Sharad Khurana
- Department of Medicine, University of Arizona, Tucson, AZ, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
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Pereda MA, Hosahalli Vasanna S, Desai NJ, Deng V, Owusu-Ansah A, Dallas MH, Pateva I, Dalal J. Case report: Daratumumab treatment in pre-transplant alloimmunization and severe hemolytic anemia. Front Immunol 2022; 13:1055473. [PMID: 36524117 PMCID: PMC9744936 DOI: 10.3389/fimmu.2022.1055473] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/11/2022] [Indexed: 11/30/2022] Open
Abstract
Daratumumab, a CD38 monoclonal antibody that has been FDA-approved to treat multiple myeloma, has acquired popularity and is used off-label for both auto- and alloantibody mediated disorders, particularly in refractory/resistant circumstances. Much of the published data for its use in pediatric blood disorders has been in post-transplant autoimmune cytopenias. Here we describe three patients in whom daratumumab was used outside of post-transplant autoimmune cytopenias, highlighting further potential uses of this medication.
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Affiliation(s)
- Maria A. Pereda
- Department of Pediatrics, Division of Pediatric Hematology Oncology, University Hospitals Rainbow Babies & Children’s Hospital, Cleveland, OH, United States,School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Smitha Hosahalli Vasanna
- Department of Pediatrics, Division of Pediatric Hematology Oncology, University Hospitals Rainbow Babies & Children’s Hospital, Cleveland, OH, United States,School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Neha J. Desai
- Department of Pediatrics, Division of Pediatric Hematology Oncology, University Hospitals Rainbow Babies & Children’s Hospital, Cleveland, OH, United States,School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Victoria Deng
- School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Amma Owusu-Ansah
- Department of Pediatrics, Division of Pediatric Hematology Oncology, University Hospitals Rainbow Babies & Children’s Hospital, Cleveland, OH, United States,School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Mari H. Dallas
- Department of Pediatrics, Division of Pediatric Hematology Oncology, University Hospitals Rainbow Babies & Children’s Hospital, Cleveland, OH, United States,School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Irina Pateva
- Department of Pediatrics, Division of Pediatric Hematology Oncology, University Hospitals Rainbow Babies & Children’s Hospital, Cleveland, OH, United States,School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Jignesh Dalal
- Department of Pediatrics, Division of Pediatric Hematology Oncology, University Hospitals Rainbow Babies & Children’s Hospital, Cleveland, OH, United States,School of Medicine, Case Western Reserve University, Cleveland, OH, United States,*Correspondence: Jignesh Dalal,
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