Daratumumab in the Management of Red Cell Aplasia Following Allogeneic Hematopoietic Stem Cell Transplantation.

IF 2.3 3区 医学 Q2 HEMATOLOGY European Journal of Haematology Pub Date : 2024-11-04 DOI:10.1111/ejh.14341
Nihar Desai, Auro Viswabandya, Dennis Dong Hwan Kim, Jeffrey H Lipton, Jonas Mattsson, Arjun Datt Law
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Abstract

Pure red cell aplasia (PRCA) is a rare but significant complication following major ABO-incompatible allogeneic hematopoietic stem cell transplantation (HSCT). The persistence of recipient B lymphocytes producing anti-donor isohemagglutinins leads to reticulocytopenia and anemia, often resulting in transfusion dependence. Current treatment options for post-HSCT PRCA are limited and frequently yield suboptimal responses, complicating patient management. Herein, we report three cases of post-HSCT PRCA successfully managed with daratumumab, a monoclonal antibody targeting CD38-expressing plasma cells. All patients demonstrated rapid reticulocyte recovery and transfusion independence after daratumumab treatment, despite prior treatment failures. These findings suggest that daratumumab may provide a more effective therapeutic approach, with a favorable safety profile compared to traditional therapies. Given its demonstrated efficacy and safety, daratumumab warrants consideration as a first-line treatment for post-HSCT PRCA, potentially improving patient quality of life and reducing transfusion-related complications. Further studies should explore optimal dosing and long-term outcomes.

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达拉单抗用于治疗异基因造血干细胞移植后的红细胞增生症。
纯红细胞增生症(PRCA)是 ABO 不相容异基因造血干细胞移植(HSCT)后出现的一种罕见但严重的并发症。产生抗供体异血凝素的受体B淋巴细胞持续存在,导致网织红细胞减少和贫血,常常导致输血依赖。目前,针对造血干细胞移植后 PRCA 的治疗方案有限,而且经常产生不理想的反应,使患者管理变得更加复杂。在此,我们报告了三例成功使用 Daratumumab(一种靶向 CD38 表达浆细胞的单克隆抗体)治疗 HSCT 后 PRCA 的病例。尽管之前的治疗失败,但所有患者在接受达拉土单抗治疗后,网织红细胞均迅速恢复并不再输血。这些研究结果表明,与传统疗法相比,daratumumab 可以提供一种更有效的治疗方法,而且安全性良好。鉴于daratumumab已被证明具有疗效和安全性,因此值得考虑将其作为HSCT后PRCA的一线治疗方法,这有可能改善患者的生活质量并减少输血相关并发症。进一步的研究应探讨最佳剂量和长期疗效。
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来源期刊
CiteScore
5.50
自引率
0.00%
发文量
168
审稿时长
4-8 weeks
期刊介绍: European Journal of Haematology is an international journal for communication of basic and clinical research in haematology. The journal welcomes manuscripts on molecular, cellular and clinical research on diseases of the blood, vascular and lymphatic tissue, and on basic molecular and cellular research related to normal development and function of the blood, vascular and lymphatic tissue. The journal also welcomes reviews on clinical haematology and basic research, case reports, and clinical pictures.
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