Targeting CD38 in relapsed /refractory T-cell acute lymphoblastic leukemia/lymphoma: A systematic review of daratumumab-based therapy
TL;DR
Daratumumab-based therapy may induce remission and facilitate HSCT bridging in selected patients, but findings remain hypothesis-generating because evidence is mainly from case reports and small series.
Abstract
Background Relapsed/refractory (R/R) T-cell acute lymphoblastic leukemia/lymphoma (T-ALL/T-LBL) has poor outcomes and limited salvage options. Objectives: To evaluate the efficacy and safety of daratumumab-based therapy in R/R T-ALL/T-LBL. Design Systematic review of observational reports. Methods Sixteen reports including 34 patients treated with daratumumab-based regimens were reviewed. Baseline characteristics, treatment patterns, response, MRD status, survival, allogeneic HSCT, and safety were descriptively synthesized. Results Complete remission was reported in 30/34 patients (88.2%), partial remission in 2/34 (5.9%), and no response in 2/34 (5.9%). Among complete responders with reported MRD status, 24/29 (82.8%) achieved MRD negativity. Median PFS was 10 months (range, 0.4–45), and median OS was 10 months (range, 1.5–45), although many values reflected last follow-up. Eighteen patients (52.9%) proceeded to allogeneic HSCT; 13/18 (72.2%) were alive at last follow-up. Infusion reactions occurred in 10 patients, mostly grade 1–2. Conclusion Daratumumab-based therapy may induce remission and facilitate HSCT bridging in selected patients, but findings remain hypothesis-generating because evidence is mainly from case reports and small series.