Administration of Daratumumab in the Case of Severe Pure Red Cell Aplasia after Allogeneic Transplantation

Abstract

Pure red cell aplasia is a well-known complication of AB0 major mismatched allogeneic hematopoietic stem cell transplantation. This side effect can be selflimiting, but is occasionally persistent and treated using modalities such as steroids, anti-thymocyte globulin, erythropoietin, donor lymphocyte infusions, rituximab, or plasmapheresis. In some cases, these standard treatments have no effect. We describe a patient with pure red cell aplasia, who received an AB0 major mismatched allogeneic hematopoietic stem cell transplantation. He underwent various treatment for the pure red cell aplasia, but no reticulocytes were present. Daratumumab was started on day 60 and 69 after transplantation, and after two doses of daratumumab, reticulocytosis and the hematocrit increased. Our case clearly represents an additional successful administration of daratumumab, resulting in full recovery of the patient with pure red cell aplasia. Keywords: Allogeneic transplant, pure red cell aplasia, daratumumab, AB0 mismatch