{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:53:24Z","timestamp":1788314004876,"version":"build-2803163510"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Desensitization of antibodies against human leucocyte antigen (HLA) is an important step in allogeneic hematopoietic stem cell transplantation with mismatched or haploidentical donors. Various strategies have been established to reduce donor specific HLA antibody (DSA) and reduce risk of graft failure. These strategies target a few pathways including depleting B cells, altering plasma cells, removing as well as modifying antibodies. We present a case whereby use of the anti-CD38 monoclonal antibody daratumumab was able to successfully reduce DSA via its action of the cell surface glycoprotein highly expressed on plasma cells in a multiparous patient with early T-cell precursor acute lymphoblastic leukemia (ETP-ALL). In this case, use of daratumumab was originally intended for consolidation therapy of ETP-ALL as treatment related complications encountered during induction therapy precluded use of further systemic chemotherapy. Choice of the anti-CD38 monoclonal antibody was supported by pre-clinical studies suggesting that CD38 is robustly expressed in T-ALL blasts thereby making it a potential effective target for daratumumab. It was through the inadvertent use of this novel agent for ETP-ALL consolidation therapy that a coinciding benefit of reduction in DSA was also achieved. In summary, daratumumab can be considered as a second line or salvage option for desensitization of DSA prior to haploidentical stem cell transplantation especially in multiparous ethnic-minority patients whom we often grapple with the issues of lack of donor availability and multiple DSA.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1734705","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T06:56:25Z","timestamp":1769064985000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Case Report: Dual impact of daratumumab in early T-cell precursor acute lymphoblastic leukemia -- consolidation therapy achieves remission and eliminates donor-specific HLA antibodies"],"prefix":"10.3389","volume":"17","author":[{"given":"Kye Ling","family":"Wong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tertius","family":"Tuy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Quek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeh Ching","family":"Linn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0039.2009.01291.x","article-title":"A short history of HLA","volume":"74","author":"Thorsby","year":"2009","journal-title":"Tissue Antigens"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-06-097386","article-title":"High-resolution donor-recipient HLA matching contributes to the success of unrelated donor marrow transplantation","volume":"110","author":"Lee","year":"2007","journal-title":"Blood"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.916200","article-title":"Donor specific HLA antibody in hematopoietic stem cell transplantation: Implications for donor selection","volume":"13","author":"Krummey","year":"2022","journal-title":"Front Immunol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1111\/tan.14704","article-title":"Prevalence and risk factors of antibodies to HLA according to different cut-off values of mean fluorescence intensity in haploidentical allograft candidates: A prospective study of 3805 subjects","volume":"100","author":"Ma","year":"2022","journal-title":"HLA"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1003032","article-title":"Daratumumab, a novel therapeutic human CD38 monoclonal antibody, induces killing of multiple myeloma and other hematological tumors","volume":"186","author":"de Weers","year":"2011","journal-title":"J Immunol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e31679","DOI":"10.1002\/pbc.31679","article-title":"Venetoclax plus Daratumumab Bridging Allo-HSCT in early T-Cell precursor acute lymphoblastic leukemia","volume":"72","author":"Meng","year":"2025","journal-title":"Pediatr Blood Cancer"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-024-06118-8","article-title":"A complete response with daratumumab, venetoclax, azacitidine and dexamethasone in a heavily pre-treated, chemo-refractory early T-precursor acute lymphoblastic leukemia\/lymphoma patient","volume":"104","author":"Kaya","year":"2025","journal-title":"Ann Hematol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01620-2","article-title":"The 5th edition of the world health organization classification of haematolymphoid tumours: lymphoid neoplasms","volume":"36","author":"Alaggio","year":"2022","journal-title":"Leukemia"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26751","article-title":"The international consensus classification of myeloid neoplasms and acute Leukemias: myeloproliferative neoplasms","volume":"98","author":"Thiele","year":"2022","journal-title":"Am J Hematology"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-08-661702","article-title":"Early T-cell precursor acute lymphoblastic leukemia\/lymphoma (ETP-ALL\/LBL) in adolescents and adults: a high-risk subtype","volume":"127","author":"Jain","year":"2016","journal-title":"Blood"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.750789","article-title":"Early T-cell precursor acute lymphoblastic leukemia: diagnosis, updates in molecular pathogenesis, management, and novel therapies","volume":"11","author":"Sin","year":"2021","journal-title":"Front Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.225078","article-title":"Unique clinico-biological, genetic and prognostic features of adult early T-cell precursor acute lymphoblastic leukemia","volume":"105","author":"Genesc\u00e0","year":"2019","journal-title":"Haematologica"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26144","article-title":"Outcome of T-cell acute lymphoblastic leukemia\/lymphoma: Focus on near-ETP phenotype and differential impact of nelarabine","volume":"96","author":"Morita","year":"2021","journal-title":"Am J Hematology"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e000630","DOI":"10.1136\/jitc-2020-000630","article-title":"Flow cytometric evaluation of CD38 expression levels in the newly diagnosed T-cell acute lymphoblastic leukemia and the effect of chemotherapy on its expression in measurable residual disease, refractory disease and relapsed disease: an implication for anti-CD38 immunotherapy","volume":"8","author":"Tembhare","year":"2020","journal-title":"J ImmunoTherapy Cancer"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-07-794214","article-title":"Preclinical efficacy of daratumumab in T-cell acute lymphoblastic leukemia","volume":"131","author":"Bride","year":"2018","journal-title":"Blood"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2018.192757","article-title":"CD38 as a therapeutic target for adult acute myeloid leukemia and T-cell acute lymphoblastic leukemia","volume":"104","author":"Naik","year":"2018","journal-title":"Haematologica"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16154","article-title":"Will Daratumumab be the next game changer in early thymic precursor-acute lymphoblastic leukaemia","volume":"187","author":"Mirgh","year":"2019","journal-title":"Br J Haematology"},{"key":"B18","doi-asserted-by":"publisher","first-page":"e29993","DOI":"10.1002\/pbc.29993","article-title":"Outcomes of patients who underwent treatment for anti-HLA donor-specific antibodies before receiving a haploidentical hematopoietic cell transplant","volume":"69","author":"Lipsitt","year":"2022","journal-title":"Pediatr Blood Cancer"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1007\/s12288-023-01712-8","article-title":"Daratumumab for De-sensitization of Donor Specific Antibodies: Is it a Quicker and Easier way","volume":"40","author":"Mehta","year":"2023","journal-title":"Indian J Hematol Blood Transfusion"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2018121254","article-title":"Daratumumab in sensitized kidney transplantation: potentials and limitations of experimental and clinical use","volume":"30","author":"Kwun","year":"2019","journal-title":"J Am Soc Nephrology"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1177\/2050313x231211050","article-title":"Blood group-specific apheresis in combination with daratumumab as a rescue therapy of acute antibody-mediated rejection in a case of ABO- and human leukocyte antigen-incompatible kidney transplantation","volume":"11","author":"S\u00fcsal","year":"2023","journal-title":"SAGE Open Med Case Rep"},{"key":"B22","doi-asserted-by":"publisher","first-page":"S474","DOI":"10.1016\/j.healun.2023.02.1313","article-title":"(1102) Daratumumab for chronic antibody mediated rejection and subsequent successful pediatric heart-Kidney retransplantation","volume":"42","author":"McCormick","year":"2023","journal-title":"J Heart Lung Transplant"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2023.06.018","article-title":"Daratumumab for antibody-mediated rejection: Is it time to target the real culprit","volume":"23","author":"de Nattes","year":"2023","journal-title":"Am J Transplant"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.htct.2021.11.019","article-title":"Daratumumab for donor-specific anti-HLA antibody desensitization in a case of HLA-mismatched allogeneic stem cell transplantation","volume":"45","author":"Ibrahim","year":"2023","journal-title":"Hematology Transfusion Cell Ther"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1177\/09636897221132502","article-title":"A case of daratumumab-induced significant decrease in donor-specific HLA antibodies and remission induction before haploidentical stem cell transplantation in a refractory B-ALL patient","volume":"31","author":"Li","year":"2022","journal-title":"Cell Transplantation"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.19289","article-title":"Donor-specific antibody desensitization with daratumumab prior to haematopoietic cell transplant for sickle cell disease: A case report","volume":"204","author":"Kunvarjee","year":"2024","journal-title":"Br J Haematology"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1734705\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T06:56:26Z","timestamp":1769064986000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1734705\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,22]]},"references-count":26,"alternative-id":["10.3389\/fimmu.2026.1734705"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1734705","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,22]]},"article-number":"1734705"}}