期刊
CELL TRANSPLANTATION
卷 31, 期 -, 页码 -出版社
SAGE PUBLICATIONS INC
DOI: 10.1177/09636897221132502
关键词
acute lymphoblastic leukemia; haploidentical stem cell transplantation; donor-specific anti-HLA antibodies; daratumumab
This study explores the method of eliminating DSA in haplo-SCT. The combination therapy with daratumumab significantly reduces DSA levels and allows for successful haplo-SCT.
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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