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An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells
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Severe cytomegalovirus enterocolitis developing following daratumumab exposure in three patients with multiple

Noa Lavi1, Doaa Okasha1, Edmond Sabo2

  • 1Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel.

European Journal of Haematology
|August 19, 2018
PubMed
Abstract

Insights

Cytomegalovirus (CMV) infections can cause severe gastrointestinal disease in heavily pretreated multiple myeloma (MM) patients receiving daratumumab. These opportunistic infections may be linked to novel MM therapies, necessitating further investigation.

Area of Science:

  • Oncology
  • Infectious Diseases
  • Immunology

Background:

  • Cytomegalovirus (CMV) reactivation is a known risk in multiple myeloma (MM) patients post-bortezomib and autologous stem cell transplantation (ASCT).
  • Limited data exists on CMV infections in MM patients not treated with bortezomib or ASCT, especially with newer therapies.

Observation:

  • Three heavily pretreated MM patients, who had undergone ASCT previously, developed severe CMV-related gastrointestinal disease.
  • These patients were receiving daratumumab-containing combination regimens.
  • The observed CMV infections included CMV colitis, with one case of concurrent CMV duodenitis and another with CMV retinitis.

Findings:

  • All patients experienced prolonged CMV disease courses requiring extended antiviral treatment.
  • The study suggests a potential association between daratumumab therapy, in combination with other immunosuppressive agents, and severe CMV gastrointestinal disease.
  • These findings highlight the risk of opportunistic infections in MM patients undergoing multiple treatment lines.

Implications:

  • Novel MM treatments like daratumumab may increase the risk of opportunistic infections, including severe CMV disease, in patients with profound immunosuppression.
  • Increased patient survival with novel therapies necessitates vigilance for rare opportunistic infections.
  • Further long-term follow-up studies are crucial to understand the side effects of agents like daratumumab in MM patients.
Keywords:
cytomegalovirusdaratumumabmultiple myeloma

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