CD38: From Positive to Negative Expression after Daratumumab Treatment
Bonell Patiño-Escobar1, Roberto Ramos1, Maximo Linares1
1Hematology, Instituto Nacional de Cancerología, Bogota, COL.
Insights
Daratumumab treatment for multiple myeloma can lead to CD38 expression negativization in plasma cells. This case study shows a patient developing this resistance mechanism after four treatment cycles.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- CD38 is a glycoprotein highly expressed on plasma cells (PC) in multiple myeloma.
- Daratumumab, a CD38-specific antibody, is approved for multiple myeloma treatment.
- CD38 expression negativization is a potential resistance mechanism.
Abstract:
CD38 is a glycoprotein expressed at a low level in myeloid and lymphoid tissues. However, it is highly and homogeneously expressed in plasma cells (PC) in multiple myeloma. Daratumumab is a human CD38-specific IgG1 antibody available for the treatment of multiple myeloma in Colombia. It has been authorized in relapsed/refractory disease as front-line treatment for non-eligible stem cell transplantation patients by INVIMA (Instituto Nacional de Vigilancia de Medicamentos y Alimentos) that is the regulatory agency. Daratumumab treatment has been associated with the negativization of the expression of CD38 in PC, demonstrating a resistance mechanism under the clonal evolution theory. We report the case of a 63-year-old male, diagnosed with a relapsed/refractory multiple myeloma, heavily treated, who expressed strong CD38 marker at the beginning of the treatment, with a posterior negativization of CD38 after four cycles of treatment with daratumumab.
