Failure of mobilization of hematopoietic stem cells associated with elevated serum levels of anti-CD38 monoclonal antibody

Eur J Haematol. 2023 Aug;111(2):318-321. doi: 10.1111/ejh.14008. Epub 2023 May 20.

Abstract

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.

Keywords: daratumumab; impaired mobilization; mass-spectrometry; multiple myeloma.

Publication types

  • Case Reports

MeSH terms

  • ADP-ribosyl Cyclase 1 / metabolism
  • Antibodies, Monoclonal / pharmacology
  • Antibodies, Monoclonal / therapeutic use
  • Antineoplastic Agents* / therapeutic use
  • Hematopoietic Stem Cells / metabolism
  • Humans
  • Multiple Myeloma* / diagnosis
  • Multiple Myeloma* / drug therapy

Substances

  • ADP-ribosyl Cyclase 1
  • daratumumab
  • Antineoplastic Agents
  • Antibodies, Monoclonal