Daratumumab for PRCA after HCT : study and practical considerations from the EBMT Transplant Complications Working Party
Gagelmann, N. (Universitätsklinikum Hamburg-Eppendorf (UKE))
Peczynski, Christophe (Hôpital Saint-Antoine (Paris, França))
Boreland, William (Hôpital Saint-Antoine (Paris, França))
Kulagin, Alexander (Pavlov University)
Esquirol, Albert (Institut de Recerca Sant Pau)
Kuball, Jürgen (University Medical Center Utrecht)
Bethge, Wolfgang (Universitaet Tuebingen)
Maertens, Johan (UZ Leuven (Bèlgica))
Stölzel, Friedrich (University Medical Center Schleswig-Holstein)
Forcade, Edouard (Hopital Haut-Leveque)
Collin, Matthew (RVI Newcastle)
Kroeger, Nicolaus (Universitätsklinikum Hamburg-Eppendorf (UKE))
López Corral, Lucia (Hospital Clínico Universitario (Salamanca))
Mussetti, Alberto (Hospital Duran i Reynals (Hospitalet del Llobregat, Catalunya))
Bloor, Adrian (Christie Hospital Manchester)
Ladetto, Marco (H SS. Antonio e Biagio)
Schoemans, Hélène (UZ Leuven (Bèlgica))
Penack, Olaf (University Medicine Berlin)
Moiseev, Ivan (Pavlov University)
Peric, Zinaida (University of Rijeka)
Witte, Moniek de (University Medical Center Utrecht)
Broers, Annoek E.C. (Erasmus MC Cancer Institute)
Jost, Edgar (University Hospital Aachen (Alemanya))
Sica, Simona (Universita Cattolica S. Cuore)
Errico, Gerardo (Nottingham City Hospital)
Parma, Matteo (Ospedale San Gerardo (Itàlia))
Choi, Goda (University Medical Center Groningen)
Di Chio, Maria Chiara (University of Milano)
Finazzi, Maria Chiara (Secretary and Italian National BMT Registry - GITMO)
Rifon, Jose (Clínica Universidad de Navarra)
Universitat Autònoma de Barcelona. Departament de Medicina

Data:	2025
Resum:	Pure red cell aplasia (PRCA) is a relevant complication after ABO-mismatched allogeneic hematopoietic cell transplantation (HCT). No standard treatment exists, and practice is heterogenous. In this study, we took advantage of an international collaboration to describe characteristics and outcomes of patients receiving daratumumab for PRCA following first allogeneic HCT. We identified 45 patients meeting these criteria (median patient age, 56 years). The median time from HCT to PRCA was 55 days (IQR, 36-116) and all patients were transfusion-dependent at time of daratumumab start. Daratumumab was first-line treatment in 16 patients (36%), most patients (67%) received daratumumab intravenously, and median time from PRCA diagnosis and daratumumab start was 88 days (IQR, 59-219). Incidence of transfusion independence was 69% (95% confidence interval [CI], 52-80%) at 6 months and 80% (95% CI, 62-90%) at 12 months. Incidences of hemoglobin and reticulocyte recoveries were respectively 56 and 78% at 6 months and 65 and 83% at 12 months. Survival at 12 months was 81%, and of 8 deaths, 7 were GVHD- or infection-related. One death was associated with hemolytic anemia. This is the first international and largest study on the use of daratumumab for PRCA after allogeneic HCT, showing high response rates superior to that reported for other treatments. Seven incidents of severe adverse events (mostly infections) underscore the need for close monitoring, proactive management, and comparative studies to determine the role for daratumumab for PRCA. Last, based on these data and a comprehensive literature review, we provide practical consideration for modern PRCA treatment. (Figure presented. ).
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Adult ; Aged ; Antibodies, Monoclonal ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Middle Aged ; Red-Cell Aplasia, Pure ; Transplantation, Homologous
Publicat a:	Blood Cancer Journal, Vol. 15, Num. 1 (December 2025) , p. 106, ISSN 2044-5385

DOI: 10.1038/s41408-025-01315-8
PMID: 40467580

8 p, 776.7 KB

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