Infectious complications and NK cell depletion following daratumumab treatment of Multiple Myeloma.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2019
Historique:
received: 23 11 2017
accepted: 17 01 2019
entrez: 14 2 2019
pubmed: 14 2 2019
medline: 5 11 2019
Statut: epublish

Résumé

Treatment with Daratumumab (Dara), a monoclonal anti-CD38 antibody of IgG1 subtype, is effective in patients with multiple myeloma (MM). However, Dara also impairs the cellular immunity, which in turn may lead to higher susceptibility to infections. The exact link between immune impairment and infectious complications is unclear. In this study, we report that nine out of 23 patients (39%) with progressive MM had infectious complications after Dara treatment. Five of these patients had viral infections, two developed with bacterial infections and two with both bacterial and viral infections. Two of the viral infections were exogenous, i.e. acute respiratory syncytial virus (RSV) and human metapneumovirus (hMPV), while five consisted of reactivations, i.e. one herpes simplex (HSV), 1 varicella-zoster (VZV) and three cytomegalovirus (CMV). Infections were solely seen in patients with partial response or worse. Assessment of circulating lymphocytes indicated a selective depletion of NK cells and viral reactivation after Dara treatment, however this finding does not exclude the multiple components of viral immune-surveillance that may get disabled during this monoclonal treatment in this patient cohort. These results suggest that the use of antiviral and antibacterial prophylaxis and screening of the patients should be considered.

Identifiants

pubmed: 30759167
doi: 10.1371/journal.pone.0211927
pii: PONE-D-17-41377
pmc: PMC6374018
doi:

Substances chimiques

Antibodies, Monoclonal 0
daratumumab 4Z63YK6E0E

Banques de données

figshare
['10.6084/m9.figshare.7599350']

Types de publication

Clinical Trial Comparative Study Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0211927

Déclaration de conflit d'intérêts

Genmab A/S, and Janssen Biotech, commercial companies, provided support by providing free materials for the study. There are no patents, products in development or marketed products to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

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Auteurs

Hareth Nahi (H)

Division of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.

Michael Chrobok (M)

Division of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.

Charlotte Gran (C)

Division of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden.

Johan Lund (J)

Division of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.

Astrid Gruber (A)

Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.

Gösta Gahrton (G)

Division of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.

Per Ljungman (P)

Division of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.
Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Stockholm, Sweden.

Arnika Kathleen Wagner (AK)

Division of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.

Evren Alici (E)

Division of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.
Cell Therapies Institute, College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida.

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