Table 1:
Reported Use of Daratumumab for DSA Desensitization
| Study | Sex, Age, Diagnosis | Desensitization regimens | DSA MFI (range) | Graft Source | Conditioning | Time to neutrophil engraftment (days) | Donor Chimerism |
|---|---|---|---|---|---|---|---|
| Lipsitt, et al.4 | Female, 21 y Severe aplastic anemia |
1st
course (Day −147 to 107): Bortezomib (6 doses) Rituximab (4 doses) TPE (5 sessions) 2nd course (Day −93 to −10): Daratumumab (6 doses) Rituximab (2 doses), TPE with IVIg (8 sessions) |
Baseline: 8000–25000 Pre-Transplant: <1000 −8000 Post-Transplant: <2000 |
Haploidentical (related) | RIC (ATG, FLU, CY, TBI) |
14 | Day +28 100% |
| Li, et al.14 | Female, 36 y B cell acute lymphoblastic leukemia |
Leukemia therapy included two cycles of daratumumab combined with etoposide and venetoclax Desensitization post daratumumab: Prednisone (Day −7 to day 0) IVIg (0.5 g/kg, on day −2, −1) |
Baseline: 14776 – 19606 Post 2 cycles: 6366 – 10649 Day 0: 6141 – 12144 Day +7: All negative |
Haploidentical (related) | MAC (TBI, CY, FLU, ARA-C) |
17 | Day +28 100% |
| Ibrahim, et al.15 | Female, 60 y JAK2 mutated post-essential thrombocythemia myelofibrosis |
First course: Rituximab TPE (3 sessions) Second course: Daratumumab (8 doses) Third course: Daratumumab (9 doses) Bortezomib (8 doses) Followed by TPE (7 sessions) with IVIg, and tacrolimus and MMF (Day – 15 to −1) |
Baseline: 18600 Post 1st course: 7069 Post 2nd course: 248 12-week rebound: 11786 Post 3rd course: 4921 Day −1: 534 |
9/10- HLA matched unrelated donor | MAC (TT, BU, FLU) |
25 | Day +30, CD33 100% Day +60 CD3 100% |
DSA: donor specific antibody; MFI: mean fluorescent intensity; TPE: therapeutic plasma exchange; IVIg: intravenous immunoglobulin; MMF: mycophenolate mofetil; RIC: reduced-intensity conditioning; MAC: myeloablative conditioning; ATG: antithymocyte globulin; FLU: fludarabine; CY: cyclophosphamide; ARA-C: cytarabine; BU: busulfan; TT: thiotepa