Successful treatment of refractory donor‐specific‐human leukocyte antigen‐antibody‐induced primary graft‐failure with daratumumab: A case report

Donor‐specific anti‐human leukocyte antigen (HLA) antibodies represent a main cause of primary graft failure specifically in the setting of haploidentical stem cell transplantation. Newer therapy strategies including daratumumab could overcome some of these limitations. We describe the case of a pat...

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Published inEJHaem Vol. 5; no. 4; pp. 863 - 866
Main Authors Lesan, Vadim, Melivadze, Ketevani, Hein, Johannes, Ahlgrimm, Manfred, Schunk, Stefan, Bewarder, Moritz, Christofyllakis, Konstantinos, Bittenbring, Joerg Thomas, Thurner, Lorenz
Format Journal Article
LanguageEnglish
Published United States John Wiley & Sons, Inc 01.08.2024
Wiley
Subjects
acute leukemia
Acute myeloid leukemia
Allografts
Antibodies
Antigens
Apheresis
Bone marrow
Chemotherapy
Combination therapy
Conflicts of interest
Disease prevention
engraftment
Graft rejection
Graft versus host disease
Granulocytes
Histocompatibility antigen HLA
Leukemia
Leukocytes
Neutrophils
Patients
Plasma
Plasmapheresis
Remission (Medicine)
Stem cell transplantation
engraftment
antibodies
acute leukemia
Online AccessGet full text
ISSN2688-6146
2688-6146
DOI10.1002/jha2.936

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Abstract Donor‐specific anti‐human leukocyte antigen (HLA) antibodies represent a main cause of primary graft failure specifically in the setting of haploidentical stem cell transplantation. Newer therapy strategies including daratumumab could overcome some of these limitations. We describe the case of a patient with refractory acute myeloid leukemia. A haploidentical allogeneic stem cell transplantation was therefore initiated. HLA‐antibodies testing revealed a high titer of donor‐specific antibodies. First desensitization therapy failed, resulting in primary graft failure. A second desensitization regimen including plasmapheresis, intravenous gammaglobulins, and daratumumab resulted in good engraftment. Daratumumab is a promising and effective desensitization option in high‐risk allo‐sensitized patients undergoing haploidentical stem cell transplantation.
AbstractList Donor-specific anti-human leukocyte antigen (HLA) antibodies represent a main cause of primary graft failure specifically in the setting of haploidentical stem cell transplantation. Newer therapy strategies including daratumumab could overcome some of these limitations. We describe the case of a patient with refractory acute myeloid leukemia. A haploidentical allogeneic stem cell transplantation was therefore initiated. HLA-antibodies testing revealed a high titer of donor-specific antibodies. First desensitization therapy failed, resulting in primary graft failure. A second desensitization regimen including plasmapheresis, intravenous gammaglobulins, and daratumumab resulted in good engraftment. Daratumumab is a promising and effective desensitization option in high-risk allo-sensitized patients undergoing haploidentical stem cell transplantation.
Abstract Donor‐specific anti‐human leukocyte antigen (HLA) antibodies represent a main cause of primary graft failure specifically in the setting of haploidentical stem cell transplantation. Newer therapy strategies including daratumumab could overcome some of these limitations. We describe the case of a patient with refractory acute myeloid leukemia. A haploidentical allogeneic stem cell transplantation was therefore initiated. HLA‐antibodies testing revealed a high titer of donor‐specific antibodies. First desensitization therapy failed, resulting in primary graft failure. A second desensitization regimen including plasmapheresis, intravenous gammaglobulins, and daratumumab resulted in good engraftment. Daratumumab is a promising and effective desensitization option in high‐risk allo‐sensitized patients undergoing haploidentical stem cell transplantation.
Donor-specific anti-human leukocyte antigen (HLA) antibodies represent a main cause of primary graft failure specifically in the setting of haploidentical stem cell transplantation. Newer therapy strategies including daratumumab could overcome some of these limitations. We describe the case of a patient with refractory acute myeloid leukemia. A haploidentical allogeneic stem cell transplantation was therefore initiated. HLA-antibodies testing revealed a high titer of donor-specific antibodies. First desensitization therapy failed, resulting in primary graft failure. A second desensitization regimen including plasmapheresis, intravenous gammaglobulins, and daratumumab resulted in good engraftment. Daratumumab is a promising and effective desensitization option in high-risk allo-sensitized patients undergoing haploidentical stem cell transplantation.Donor-specific anti-human leukocyte antigen (HLA) antibodies represent a main cause of primary graft failure specifically in the setting of haploidentical stem cell transplantation. Newer therapy strategies including daratumumab could overcome some of these limitations. We describe the case of a patient with refractory acute myeloid leukemia. A haploidentical allogeneic stem cell transplantation was therefore initiated. HLA-antibodies testing revealed a high titer of donor-specific antibodies. First desensitization therapy failed, resulting in primary graft failure. A second desensitization regimen including plasmapheresis, intravenous gammaglobulins, and daratumumab resulted in good engraftment. Daratumumab is a promising and effective desensitization option in high-risk allo-sensitized patients undergoing haploidentical stem cell transplantation.
Author Ahlgrimm, Manfred
Schunk, Stefan
Melivadze, Ketevani
Lesan, Vadim
Thurner, Lorenz
Hein, Johannes
Christofyllakis, Konstantinos
Bittenbring, Joerg Thomas
Bewarder, Moritz
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10.1159/000503951
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Copyright 2024 The Author(s). published by British Society for Haematology and John Wiley & Sons Ltd.
2024 The Author(s). eJHaem published by British Society for Haematology and John Wiley & Sons Ltd.
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Snippet Donor‐specific anti‐human leukocyte antigen (HLA) antibodies represent a main cause of primary graft failure specifically in the setting of haploidentical stem...
Donor-specific anti-human leukocyte antigen (HLA) antibodies represent a main cause of primary graft failure specifically in the setting of haploidentical stem...
Abstract Donor‐specific anti‐human leukocyte antigen (HLA) antibodies represent a main cause of primary graft failure specifically in the setting of...
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SubjectTerms acute leukemia
Acute myeloid leukemia
Allografts
Antibodies
Antigens
Apheresis
Bone marrow
Chemotherapy
Combination therapy
Conflicts of interest
Disease prevention
engraftment
Graft rejection
Graft versus host disease
Granulocytes
Histocompatibility antigen HLA
Leukemia
Leukocytes
Neutrophils
Patients
Plasma
Plasmapheresis
Remission (Medicine)
Stem cell transplantation
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Title Successful treatment of refractory donor‐specific‐human leukocyte antigen‐antibody‐induced primary graft‐failure with daratumumab: A case report
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