Acute leukoencephalopathy associated with daratumumab treatment in POEMS syndrome: a case report

Daratumumab, a monoclonal antibody against CD38, is increasingly used in the treatment of multiple myeloma, other hematological malignancies and autoimmune diseases. Little is known about its CNS toxicity. We present a case of a patient with POEMS syndrome (syndrome of polyneuropathy, organomegaly,...

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Vydáno v:Frontiers in immunology Ročník 15; s. 1451693
Hlavní autoři: Steinegger, Lukas, Nierobisch, Nathalie, De Vere-Tyndall, Anthony, Schreiner, Bettina, Roth, Patrick, Kappos, Ludwig, Kana, Veronika, Herwerth, Marina
Médium: Journal Article
Jazyk:angličtina
Vydáno: Switzerland Frontiers Media SA 26.09.2024
Frontiers Media S.A
Témata:
Antibodies
Antibodies, Monoclonal - administration & dosage
Antibodies, Monoclonal - adverse effects
Antibodies, Monoclonal - therapeutic use
Ataxia
Autoimmune diseases
Blood pressure
Case reports
CD38 antigen
CD38-antibody
daratumumab
Edema
Encephalitis
Endocrine disorders
Female
Humans
Immunology
Immunomodulators
Ischemia
Laboratories
Leukoencephalopathies - chemically induced
Leukoencephalopathy
Magnetic Resonance Imaging
Male
Malignancy
Middle Aged
Monoclonal antibodies
Monoclonal gammopathy
Multiple myeloma
Nervous system
Patients
POEMS Syndrome - diagnosis
POEMS Syndrome - drug therapy
Polyneuropathy
rapidly progressive leukoencephalopathy
Steroids
toxic leukoencephalopathy
Toxicity
Vascular endothelial growth factor
Vigilance
POEMS
CD38-antibody
daratumumab
toxic leukoencephalopathy
rapidly progressive leukoencephalopathy
ISSN:1664-3224, 1664-3224
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Shrnutí:Daratumumab, a monoclonal antibody against CD38, is increasingly used in the treatment of multiple myeloma, other hematological malignancies and autoimmune diseases. Little is known about its CNS toxicity. We present a case of a patient with POEMS syndrome (syndrome of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes) who developed an acute leukoencephalopathy shortly after initiation of therapy with daratumumab. Case report following the CARE case report guidelines. The patient presented with symptoms of headache and diffuse worsening of a pre-existing tetraparesis. MRI showed a rapidly progressive leukoencephalopathy. Extensive diagnostic evaluation revealed no specific cause, suggesting the leukoencephalopathy to be caused by daratumumab. Our report highlights a probably rare, but clinically significant adverse effect of daratumumab and underlines the necessity of raised vigilance for neurological side effects in patients treated with daratumumab.
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Reviewed by: Ronald Antulov, University Hospital of Southern Denmark, Denmark
Edited by: Philipp Albrecht, Heinrich Heine University of Düsseldorf, Germany
Noriyuki Matsukawa, Nagoya City University, Japan
ISSN:1664-3224
1664-3224
DOI:10.3389/fimmu.2024.1451693