Failure of mobilization of hematopoietic stem cells associated with elevated serum levels of anti-CD38 monoclonal antibody.
Abhishek SethDavid MurrayFrancis K BuadiMorie A GertzUdit YadavShaji K KumarWilson I GonsalvesPublished in: European journal of haematology (2023)
Daratumumab is an anti-CD38 antibody that is increasingly incorporated in induction regimens for treating patients with newly diagnosed multiple myeloma (NDMM). Previous reports have demonstrated a lower yield of hematopoietic stem cells (HSCs) after induction with daratumumab; however, none of them reported a failure to collect an adequate number of HSCs. We describe a case of adequate HSC mobilization failure in a patient who inadvertently received excessive doses of daratumumab and was confirmed by higher-than-expected circulating levels of daratumumab by mass spectrometry. Eventual clearance of circulating daratumumab was associated with the successful mobilization and harvesting of HSCs.
Keyphrases
- multiple myeloma
- monoclonal antibody
- stem cells
- newly diagnosed
- mass spectrometry
- induced apoptosis
- bone marrow
- emergency department
- case report
- high resolution
- nk cells
- oxidative stress
- signaling pathway
- cell cycle arrest
- liquid chromatography
- endoplasmic reticulum stress
- weight loss
- cell proliferation
- gas chromatography
- drug induced