Relapsed/refractory multiple myeloma-transformed plasma-cell leukemia successfully treated with daratumumab followed by autologous stem cell transplantation

Relapsed/refractory multiple myeloma-transformed plasma-cell leukemia successfully treated with daratumumab followed by autologous stem cell transplantation

Blog Article

Daratumumab is a humanized anti-CD38 IgG1 monoclonal antibody which could be used for multiple myeloma (MM).MM with plasma-cell leukemia (PCL) transformation is highly aggressive and is resistant to conventional therapy.Novel therapeutics are needed for PCL, and daratumumab may play role.We report a case of relapsed/refractory multiple myeloma (RRMM)-transformed PCL successfully treated with daratumumab.

The case was a 42-year-old man who was diagnosed with MM 2 years ago and relapsed after six cycles of bortezomib-based chemotherapy.The patient rapidly developed hyperleukocytosis and disseminated intravascular coagulation, and was galaxy harmony nc diagnosed with PCL.Daratumumab-based therapy was tried and the case miraculously obtained complete remission (CR) after four doses of a weekly infusion of daratumumab.Finally the patient received autologous hematopoietic stem-cell transplantation (auto-HSCT) and maintained CR.

Moreover, we monitored the immune cell dynamics by flow cytometry (FCM) during daratumumab-based treatment.The immune cell subset analysis revealed significant down-regulation of animed blue lotion topical spray CD38+ natural killer (NK) cells, regulatory T cells (Tregs) and regulatory B cells (Bregs).Meanwhile cytotoxic T-lymphocyte expansion was observed.In conclusion, daratumumab could rapidly decrease tumor burden, improve the condition of the PCL patient, and serve as a bridging salvage chemotherapy for further chimeric antigen recptor T cell therapy (Car-T) or HSCT, which could potentially improve patient survival.

The immune cell dynamic findings in this case suggest that the immunomodulatory mechanism may contribute to the antimyeloma effect of daratumumab.