Daratumumab for CD20^-CD38⁺ Relapsed/Refractory Diffuse Large B-Cell Lymphoma

Patients with R/R DLBCL (relapsed/refractory diffuse large B-cell lymphoma) treated with rituximab-based regimens often have a reduction in the expression level of CD20. Replacement of target proteins for new targeted chemotherapy has become a popular direction for the treatment of R/R DLBCL. To investigate whether Daratumumab can be an effective alternative to targeted agents as monotherapy or combination chemotherapy in patients with CD20-CD38+ R/R DLBCL who have failed to respond to CD20 monoclonal antibody treatment and its adjuvant effect on subsequent CAR-T (chimeric antigen receptor T-cell immunotherapy). A total of four CD20-CD38+ R/R DLBCL patients treated with multiple lines of Daratumumab-based combination chemotherapy were retrospectively collected. For eligible patients, CAR-T therapy was used afterwards. Also, the authors successfully constructed allografted tumour models in mice. Relevant evaluation showed that four patients who received Daratumumab combination chemotherapy had varying degrees of remission after treatment, including 2 CR, 1 PR and 1 SD. The 1-year OS rate was 75%, the 1-year PFS rate was 50% and mOS was 12 months. Adverse effects were moderate and reversible, and no treatment-related deaths occurred. Daratumumab therapy led to a successful transition to CAR-T in two patients. Among them, grade 1 CRS occurred. These cases demonstrated that Daratumumab combination therapy has a good application prospect in the treatment of CD20-CD38+ R/R DLBCL and is helpful for the bridge of CAR-T therapy.