Deng B, Gao R, Yang B, Lei WB, Xue MF, Wang JS, Zhao P. Seven-years post allogeneic hematopoietic stem cell transplantation pure red cell aplastic anemia cured with daratumumab: A case report and review of literature. World J Clin Cases 2024; 12(24): 5604-5612 [PMID: 39188601 DOI: 10.12998/wjcc.v12.i24.5604]
Corresponding Author of This Article
Peng Zhao, MD, Doctor, Department of Hematology, The Affiliated Hospital of Guizhou Medical University, No. 28 Guiyi Street, Guiyang 550001, Guizhou Province, China. zhaopeng_6786262@hotmail.com
Research Domain of This Article
Hematology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 26, 2024; 12(24): 5604-5612 Published online Aug 26, 2024. doi: 10.12998/wjcc.v12.i24.5604
Seven-years post allogeneic hematopoietic stem cell transplantation pure red cell aplastic anemia cured with daratumumab: A case report and review of literature
Bo Deng, Department of Haematology, Guizhou Hospital, The First Affiliated Hospital of Sun Yat-sen University, Guiyang 550001, Guizhou Province, China
Rui Gao, Peng Zhao, Department of Hematology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guizhou Province, China
Bing Yang, Wen-Bing Lei, Ming-Fang Xue, School of Clinical Medicine, Guizhou Medical University, Guiyang 550001, Guizhou Province, China
Ji-Shi Wang, Department of Hematology, The Affiliated Hospital of Guizhou Medical University, Hematological Institute of Guizhou Province, Guiyang 550001, Guizhou Province, China
Author contributions: Deng B and Gao R contributed to manuscript writing and editing, and data collection; Yang B, Lei WB, Xue MF contributed to data analysis; Wang JS performed the treatment; Zhao P contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Supported byNatural Science Foundation of Guizhou Province, China, No. 397.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All of the authors declare that we have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peng Zhao, MD, Doctor, Department of Hematology, The Affiliated Hospital of Guizhou Medical University, No. 28 Guiyi Street, Guiyang 550001, Guizhou Province, China. zhaopeng_6786262@hotmail.com
Received: March 13, 2024 Revised: June 4, 2024 Accepted: June 26, 2024 Published online: August 26, 2024 Processing time: 119 Days and 22.8 Hours
Abstract
BACKGROUND
Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) is currently the only viable method of curing patients with acute myeloid leukaemia. In 30% to 50% of patients, donors and recipients have some level of ABO blood group incompatibility. ABO blood group incompatibility can cause antibodies against the donor's red blood cells to persist in the recipient's body, resulting in a delay of several months in the recovery of red blood cells. A number of different treatments have been reported for post-transplant pure red cell aplastic anaemia (PRCA), such as plasmapheresis, donor lymphocyte infusions, anti-thymocyte globulin, rituximab and steroids.
CASE SUMMARY
A 41-year-old female diagnosed with acute myeloid leukaemia underwent peripheral blood allogeneic haematopoietic stem cell transplantation in November 2013 from an HLA matched unrelated donor. The donor was AB-positive and the recipient was O-positive. The patient was diagnosed with PRCA three months after receiving the donor stem cell transplant. After failing multiple lines of therapy, the patient applied for daratumumab. After receiving three doses of daratumumab, the patient developed a reticulocyte response and no longer required blood transfusions.
CONCLUSION
The use of daratumumab anti-CD38 for the remove of plasma cells is safe and effective and may be tried for refractory patients with PRCA after undergoing allo-HSCT for ABO incompatibility.
Core Tip: Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) is currently the only possible way to cure patients with malignant hematologic diseases. In Allo-HSCT, donors have some degree of ABO blood-group incompatibility with the recipient. An outcome of ABO incompatibility caused is pure red cell aplastic anemia (PRCA). We report a 41-year-old female diagnosed with acute myeloid leukemia received a peripheral blood allo-HSCT from an HLA-matched unrelated donor in November 2013. The patient was diagnosed with PRCA three months after allo-HSCT. After failing multiple lines of treatment, daratumumab was requested. After receiving three doses of daratumumab, the patient had a marked reticulocyte response and become transfusion independent.Using of anti-CD38 therapy with daratumumab to target residual host plasma cells is safe and effective, and it can be considered in refractory recipients with PRCA after allo-HSCT secondary to ABO incompatibility.
