Li X, Zhu H, Sui T, Zhao X, Deng Q. A Case of Daratumumab-Induced Significant Decrease in Donor-Specific HLA Antibodies and Remission Induction Before Haploidentical Stem Cell Transplantation in a Refractory B-ALL Patient.
Cell Transplant 2022;
31:9636897221132502. [PMID:
36278404 PMCID:
PMC9597015 DOI:
10.1177/09636897221132502]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective:
To explore the method of eliminating donor-specific anti-HLA antibodies (DSA)
in haploidentical stem cell transplantation (haplo-SCT).
Methods:
We present a refractory B-cell acute lymphoblastic leukemia (ALL) patient who
had strongly positive DSA, but had no human leukocyte antigen–matched donor.
Although CD38 expression on leukemia cells was negative, daratumumab
combined with etoposide and venetoclax therapy was chosen for her.
Results:
She achieved a significant decrease in DSA levels and complete remission on
the combination therapy with daratumumab. She then received a haplo-SCT from
a daughter as a donor and had a successful engraftment of donor stem cell.
In haplo-SCT, strongly positive DSA levels, directed against donor HLA
antigens, could be significantly reduced by daratumumab therapy before
transplantation and successfully bridge subsequent haplo-SCT.
Conclusion:
Although CD38 expression is negative in leukemia cells, refractory B-ALL
patients may still benefit from combination therapy with daratumumab. We
need further clinical observation.
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