The Daratumumab Crosses the Blood Brain Barrier

Vercruyssen, Marie; Hachem, Georges El; Maerevoet, Marie

doi:10.1016/j.clml.2018.07.229

Cited by 13 publications

(9 citation statements)

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“…Daratumumab is a humanized mAb specific for CD38 and there is evidence it can cross the intact BBB, being measurable in CSF. 62 It has shown significant activity in parenchymal CNS-MM in combination with IT therapy and radiotherapy (XRT). 63 Also, in a study of relapsed / refractory MM (RRMM) with CNS involvement, a patient treated systemically with daratumumab achieved a response, clearing the CSF of plasma cells, although there was concomitant use of IT therapy.…”

Section: Future Directionmentioning

confidence: 99%

Multiple myeloma with central nervous system relapse

et al. 2020

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C entral nervous system involvement in multiple myeloma is a rare complication but carries a very poor prognosis. We provide a review of current literature, including presentation, treatment and survival data, and describe our experience in a regional hematologic malignancy diagnosis center where, over a 15-year period, ten cases were identified. Although the median age of onset, frequently between 50-60 years, is comparatively young, those diagnosed usually have a preceding diagnosis of multiple myeloma and often have had several lines of treatment. We discuss putative underlying factors such as prior treatment and associations including possible risk factors and features suggestive of a distinct biology. Central nervous system involvement may be challenging to diagnose in myeloma, displaying heterogeneous symptoms that can be confounded by neurological symptoms caused by the typical features of myeloma or treatment side-effects. We discuss the clinical features, imaging and laboratory methods used in diagnosis, and highlight the importance of considering this rare complication when neurological symptoms occur at presentation or, more commonly, during the disease pathway. In the absence of clinical trial data to inform an evidence-based approach to treatment, we discuss current and novel treatment options. Finally, we propose the establishment of an International Registry of such cases as the best way to collect and subsequently disseminate presentation, diagnostic and treatment outcome data on this rare complication of multiple myeloma.

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Section: Future Directionmentioning

confidence: 99%

Multiple myeloma with central nervous system relapse

et al. 2020

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“…Daratumumab can be measurable in CSF, demonstrating the capability to cross the BBB ( 113 ). Indeed, daratumumab has been reported to be effective in CNS-MM in combination with IT therapy and/or radiotherapy ( 26 , 114 ).…”

Section: Introductionmentioning

confidence: 99%

Central Nervous System Myeloma and Unusual Extramedullary Localizations: Real Life Practical Guidance

et al. 2022

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Central nervous system localization of multiple myeloma (CNS-MM) accounts for about 1% of all MM during disease course or even rarer at diagnosis. A difference in the origin, i.e., osteodural or primary dural vs leptomeningeal/intraparenchymal, seems to define two distinct types of intracranial myeloma, with different clinical behavior. CNS-MM may occur also as a presentation of MM. Treatment is still unsatisfactory and many treatments have been reported: chemotherapy, intrathecal therapy, and radiotherapy, with dismal prognosis. Other sites of myeloma localization could be also of interest and deserve description. Because of the rarity and aggressiveness of the disease clinicians are often doubtful on how to treat it since there is no general agreement. Moreover, recent drugs such as the anti CD38 monoclonal antibody, immunomodulatory drugs, and proteasome inhibitors have changed the treatment of patients with MM with a significant improvement in overall response and survival. The role of novel agents in CNS MM management and unusual presentations will be discussed as well as the potential role of other new immunomodulatory drugs and proteasome inhibitors that seem to cross the blood-brain barrier. The purpose of this review is to increase awareness of the clinical unusual presentation and neuroradiological findings, give practical diagnostic advice and treatment options algorithm.

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“…However, the use of bortezomib has been reported to enhance radiosensitivity and chemosensitivity ( 31 ), and studies of CNS lesion treatment with combination therapy including bortezomib should be conducted in the future. To our knowledge, one report examined the CSF transferability of daratumumab ( 32 ), and two case reports described significant activity of daratumumab for CNS lesions of MM when concomitantly used with intrathecal chemotherapy ( 33 , 34 ). There are no current data of CSF transferability and the effectiveness of isatuximab and elotuzumab for CNS lesions.…”

Section: Discussionmentioning

confidence: 99%

Multiple Myeloma with Central Nervous System Relapse Early after Autologous Stem Cell Transplantation: A Case Report and Literature Review

et al. 2021

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Few reports have so far described central nervous system (CNS) involvement in multiple myeloma (MM), which shows a poor prognosis owing to its resistance to several treatments. We herein describe a 45-year-old woman who had MM (diagnosed with IgA-κ type) with CNS relapse early after undergoing autologous hematopoietic stem cell transplantation. Because no standard treatment for CNS lesions of MM has been established, we conducted a literature review on the cerebrospinal fluid (CSF) transferability of drugs for MM, since it was considered to be a useful tool for CNS involvement. Immunomodulatory-drugs including pomalidomide exhibit a good CSF transfer ability, and, therefore, may be beneficial against the CNS involvement of MM.

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The Daratumumab Crosses the Blood Brain Barrier

Cited by 13 publications

References 0 publications

Multiple myeloma with central nervous system relapse

Multiple myeloma with central nervous system relapse

Central Nervous System Myeloma and Unusual Extramedullary Localizations: Real Life Practical Guidance

Multiple Myeloma with Central Nervous System Relapse Early after Autologous Stem Cell Transplantation: A Case Report and Literature Review

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