Acute leukoencephalopathy associated with daratumumab treatment in POEMS syndrome: a case report
Lukas Steinegger1, Nathalie Nierobisch2,3, Anthony De Vere-Tyndall2,3
1Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
Objectives:
Daratumumab, a monoclonal antibody against CD38, is increasingly used in the treatment of multiple myeloma, other hematological malignancies and autoimmune diseases. Little is known about its CNS toxicity. We present a case of a patient with POEMS syndrome (syndrome of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes) who developed an acute leukoencephalopathy shortly after initiation of therapy with daratumumab.
Methods:
Case report following the CARE case report guidelines.
Results:
The patient presented with symptoms of headache and diffuse worsening of a pre-existing tetraparesis. MRI showed a rapidly progressive leukoencephalopathy. Extensive diagnostic evaluation revealed no specific cause, suggesting the leukoencephalopathy to be caused by daratumumab.
Discussion:
Our report highlights a probably rare, but clinically significant adverse effect of daratumumab and underlines the necessity of raised vigilance for neurological side effects in patients treated with daratumumab.
