1
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Longval T, Leprêtre AC, Ravinet A, Fayard A, Forcade E, Coman T, Redjoul R, Berceanu A, Buchbinder N, Berlie G, Mappoura M, Giannotti F, Chevillon F, Robin M, Peffault de Latour R, Sicre de Fontbrune F. Efficacy and safety of Daratumumab for the treatment of ABO-incompatible pure red cell aplasia after allogenic HSCT: report from SFGM-TC. Bone Marrow Transplant 2024; 59:893-895. [PMID: 38461290 DOI: 10.1038/s41409-024-02202-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/15/2023] [Accepted: 01/08/2024] [Indexed: 03/11/2024]
Affiliation(s)
- Thomas Longval
- Division of Hematology, Department of Oncology, Geneva University Hospitals, Geneva, Switzerland.
| | | | - Aurélie Ravinet
- Hematology Department, Centre Hospitalier Universitaire Estaing, Clermont-Ferrand, France
| | - Amandine Fayard
- Hematology Department, Centre Hospitalier Universitaire Estaing, Clermont-Ferrand, France
| | - Edouard Forcade
- Hematology Department, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Tereza Coman
- Hematology Department, Gustave-Roussy, Villejuif, France
| | - Rabah Redjoul
- Hematology Department, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Ana Berceanu
- Hematology Department, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Nimrod Buchbinder
- Hematopoietic Pediatric Transplant Center, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | | | - Maria Mappoura
- Division of Hematology, Department of Oncology, Geneva University Hospitals, Geneva, Switzerland
| | - Federica Giannotti
- Division of Hematology, Department of Oncology, Geneva University Hospitals, Geneva, Switzerland
| | - Florian Chevillon
- Hematology Adolescents and Young Adults, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Marie Robin
- Hematology Transplant Unit, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Régis Peffault de Latour
- Hematology Transplant Unit, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Flore Sicre de Fontbrune
- Hematology Transplant Unit, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.
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2
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Weverling F, Roeven M, Nijssen C, Broers AEC, Dovern E, van Rhenen A, Sluis GV, Hazenberg CLE, Balen PV, Kuipers MT, de Vooght KMK, Morsink L, Kuball J, Nur E, de Witte MA. Efficacy and safety of daratumumab in pure red cell aplasia after allogeneic transplantation: Dutch real-world data. Blood Adv 2024; 8:1683-1686. [PMID: 38231018 PMCID: PMC11006807 DOI: 10.1182/bloodadvances.2023011190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/13/2023] [Accepted: 11/30/2023] [Indexed: 01/18/2024] Open
Affiliation(s)
- Flores Weverling
- Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mieke Roeven
- Department of Hematology, Radboud University Medical Center; Nijmegen, The Netherlands
| | - Clara Nijssen
- Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Annoek E. C. Broers
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Elisabeth Dovern
- Department of Hematology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Anna van Rhenen
- Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Geerte van Sluis
- Department of Hematology, Isala Hospital, Zwolle, The Netherlands
| | - Carin L. E. Hazenberg
- Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter van Balen
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Maria T. Kuipers
- Department of Hematology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Karen M. K. de Vooght
- Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Linde Morsink
- Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands
| | - Jürgen Kuball
- Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Erfan Nur
- Department of Hematology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Moniek A. de Witte
- Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
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3
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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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4
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Means RT. Pure red cell aplasia: The second hundred years. Am J Med Sci 2023; 366:160-166. [PMID: 37327996 DOI: 10.1016/j.amjms.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/05/2023] [Accepted: 06/13/2023] [Indexed: 06/18/2023]
Abstract
Pure red cell aplasia (PRCA) is a rare hematologic syndrome, characterized by an isolated normocytic anemia with severe reticulocytopenia, and defined by absence or near absence of erythroid precursors in the bone marrow. First described in 1922, PRCA may be a primary autoimmune or clonal myeloid or lymphoid disorder, but may also be secondary to other disorders of immune dysregulation/autoimmunity, to infections, to neoplasms, or to drugs. Insights from the study of PRCA have helped illuminate the understanding of the regulation of erythropoiesis. This review summarizes the classification, diagnostic, and therapeutic approach to PRCA as it begins its second century, with a particular focus on opportunities and challenges provided by new developments in the role of T-cells and T-cell regulatory mutations; the role of clonal hematopoiesis; and new developments in therapy for refractory PRCA and PRCA associated with ABO incompatible stem cell transplantation.
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Affiliation(s)
- Robert T Means
- Departments of Internal Medicine, Medical Education, and Pathology, James H. Quillen College of Medicine, Johnson City, TN, USA.
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5
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Dovern E, Biemond BJ, Nur E. Case report: Successful treatment with daratumumab for pure red cell aplasia in a patient with mixed lymphoid chimerism after ABO-mismatched stem cell transplant for sickle cell disease. Front Immunol 2023; 14:1212007. [PMID: 37426651 PMCID: PMC10326381 DOI: 10.3389/fimmu.2023.1212007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/13/2023] [Indexed: 07/11/2023] Open
Abstract
Pure red cell aplasia (PRCA) is a serious complication after ABO-mismatched allogeneic hematopoietic stem cell transplantation (HSCT). Following HSCT, persistent anti-donor isohemagglutinins against donor ABO antigens are considered the immunological cause of PRCA. Patients with post-transplant PRCA are at risk for graft rejection and prolonged red blood cell transfusion dependency. No standard treatment exists. Recently however, the anti-CD38 monoclonal antibody daratumumab has been reported to be an effective treatment for post-transplant PRCA in patients with complete donor chimerism. Here, we describe the first case of PRCA in a patient with mixed lymphoid patient/donor chimerism that was successfully treated with daratumumab. This is also the first report of a transplant recipient with sickle cell disease who was treated with this relatively new approach. Fourteen months post-transplantation and twelve months after treatment with daratumumab, our patient has a normal complete blood count and the anti-donor isohemagglutinins remain undetectable despite mixed lymphoid chimerism. Mixed chimerism is a common manifestation in adult patients with sickle cell disease transplanted with non-myeloablative conditioning and a matched sibling donor. The application of non-myeloablative HSCT for patients with sickle cell disease is steadily increasing. Therefore, the incidence of PRCA in this setting might also increase. As the risk of graft rejection due to PRCA can be especially high in patients with mixed chimerism, clinicians should be aware that daratumumab can be an effective treatment in the setting of mixed chimerism.
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Affiliation(s)
- E. Dovern
- Department of Hematology, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, Netherlands
| | - B. J. Biemond
- Department of Hematology, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, Netherlands
| | - E. Nur
- Department of Hematology, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, Netherlands
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Amsterdam, Netherlands
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6
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Vo AK, Hervig T, Reikvam H. Pure red cell aplasia after hematopoietic stem cell transplantation - experimental therapeutic approaches. Expert Opin Investig Drugs 2022; 31:881-884. [PMID: 35975626 DOI: 10.1080/13543784.2022.2113055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Not relevant.
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Affiliation(s)
- Anh Khoi Vo
- Section Hematology, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Tor Hervig
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Irish Blood Transfusion Service, Dublin, Ireland
| | - Håkon Reikvam
- Section Hematology, Department of Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
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Arslan S, Ali H, Mei M, Marcucci G, Forman S, Nakamura R, Stein A, Al Malki MM. Successful treatment of refractory pure red cell aplasia in major ABO-mismatched allogeneic hematopoietic stem cell transplant with single agent Ibrutinib. Bone Marrow Transplant 2022; 57:830-833. [PMID: 35194155 DOI: 10.1038/s41409-022-01590-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Shukaib Arslan
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA.
| | - Haris Ali
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA
| | - Mathew Mei
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA
| | - Guido Marcucci
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA
| | - Stephan Forman
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA
| | - Ryotaro Nakamura
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA
| | - Anthony Stein
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA
| | - Monzr M Al Malki
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA
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