Daratumumab in the treatment of pure red cell aplasia after pediatric allogeneic stem cell transplantation

Abstract

Pure red cell aplasia (PRCA) is a rare complication of AB0-incompatible allogeneic hematopoietic stem cell transplantation, which manifests as a partial or complete absence of erythroid lineage in recipients with normal function of other hematopoietic lineages. There is a hypothesis, that lysis of erythroid precursors occurs because of antibody formation by population of residual B-lymphocytes and/or long-lived recipient’s plasma cells, which are capable for proliferation and active expression of the CD38 marker. That is why the invention of the IgG1 monoclonal antibody to CD38 presented as a new potentially effective targeted therapeutic option for patients with refractory PPCA. The article summarize clinical data on daratumumab for the therapy of PRCA in pediatric allogeneic hematopoietic stem cell transplantation recipients. The patients' parents gave their consent to the use of their children's data, including photographs, for research purposes and in publications.

Daratumumab in post-transplantation pure red cell aplasia in adults

“…Taking into account the source of antibody production, the most reasonable principle for PRCA treatment is the depletion of long-lived plasma cells in the recipient. This hypothesis is confirmed by published clinical cases of successful use of the anti-CD38 monoclonal antibody daratumumab in PRCA [19][20][21][22][23][24].…”