Table 1.
Review of the literature about daratumumab use in warm autoimmune hemolytic anemia (wAIHA), cold agglutinin disease (CAD), and Evans' syndrome.
| Disease | N of patients | Previous treatments | Dara schedule | Time to response | Main finding | References |
|---|---|---|---|---|---|---|
| wAIHA post HSCT for ALL | 1 (19-year-old woman) | Steroids, rituximab 2 courses, high-dose cyclophosphamide, rabbit anti-thymocyte globulin, alemtuzumab, bortezomib 2 courses, mycophenolate mofetil, sirolimus, and ibrutinib | 16 mg/kg single infusion | 2–4 weeks | Daratumumab dramatically decreased red cells transfusion in a refractory patient | (8) |
| wAIHA post HSCT for ALL | 3 (pediatric cases) | Steroids, rituximab, PEX, bortezomib, MMF, sirolimus, ATG, CyA, ibrutinib, eculizumab | 16 mg/kg Pt1: 11 doses in 49 days Pt2: 4 in 17 days Pt3: 7 doses in 43 days |
Not reported | Daratumumab was effective in two out of three pediatric patients with heavily pre-treated patients, 1 died after a transient response | (9) |
| wAIHA during HSCT for Langerhans cell histiocytosis | 1 (pediatric case) | Steroids, rituximab, IVIG, Whole blood exchange | 16 mg/kg/day ×2 doses | 3 days | Daratumumab contributed to anemia recovery in a refractory patient | (10) |
| wAIHA | 1 (60-year-old woman) | Steroids, rituximab | 16 mg/kg/week ×4 doses | 10 weeks | Daratumumab induced a 20 weeks lasting response in a pre-treated patient | (12) |
| wAIHA post HSCT | 3 out of 20 pediatric AIC cases (case-control study) | Corticosteroids (75%) and rituximab (55%) | Not reported | Mean 1,069 days | Daratumumab was started at days +245, +1,028, and +2,016 following HSCT. 2 patients responded and had resolution of B-cell aplasia 759 and 1,380 days following daratumumab | (11) |
| Evans syndrome post HSCT for AA (wAIHA+ITP) | 1 (35-year-old woman) | Steroids, IVIG, CyA, eltrombopag, rituximab, bortezomib, | 16 mg/kg/week ×4 doses | 2 weeks | Daratumumab induced rapid recovery of highly pre-treated adult patient | (15) |
| Evans syndrome post HSCT for MF (wAIHA+ITP) | 1 (pediatric case) | Steroids, IVIG, rtixuimab, abatacept, bortezomib | 16 mg/kg/week ×6 doses | Immediate | Daratumumab induced immediate response in a heavily pre-treated child | (14) |
| CAD secondary to LPL | 1 (48-year-old man) | Steroids, rituximab, Bortezomib-cyclophosphamide-prednisolone | 16 mg/kg/week for week 1–8, 16 mg/kg fortnight for week 9–24, then 16 mg/kg/month | 2 weeks | Daratumumab resolved cold agglutinin peripheral symptoms and increased Hb values; cold agglutinin titer were also reduced | (13) |
wAIHA, warm autoimmune hemolytic anemia; HSCT, hematopoietic stem cell transplant; ALL, acute lymphoblastic leukemia; AA, aplastic anemia; MF, myelofibrosis; ITP, immune thrombocytopenia; LPL, lymphoplasmocytic lymphoma.