Daratumumab in Combination With High-Dose Cytarabine and Amsacrine as an Effective Salvage Therapy and Bridge to Allogeneic Hematopoietic Stem Cell Transplantation for Refractory T-Cell Acute Lymphoblastic Leukemia: A Case Report.

Abstract

Patients with refractory or relapsed T-cell acute lymphoblastic leukemia (R/R T-ALL) have dismal outcomes. While immunotherapies are growing opportunities for B-cell ALL, targeted therapies for T-ALL remain limited. The CD38 antigen, steadily expressed on T-ALL blasts, represents a relevant therapeutic target. Daratumumab, an anti-CD38 monoclonal antibody routinely used in other hematologic malignancies, could be a promising treatment option for T-ALL. We report here the achievement of a third complete response with the combination of daratumumab, high-dose cytarabine (18 g/m2), and amsacrine in an 11-year-old patient with highly aggressive relapsed T-ALL, enabling subsequent allogeneic hematopoietic stem cell transplantation.