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CASE REPORT article

Front. Immunol.
Sec. Multiple Sclerosis and Neuroimmunology
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1451693

Acute leukoencephalopathy associated with daratumumab treatment in POEMS syndrome: a case report

Provisionally accepted
Lukas Steinegger Lukas Steinegger 1*Nathalie Nierobisch Nathalie Nierobisch 1Anthony De Vere-Tyndall Anthony De Vere-Tyndall 1Bettina Schreiner Bettina Schreiner 1Patrick Roth Patrick Roth 1Ludwig Kappos Ludwig Kappos 1,2Veronika Kana Veronika Kana 1Marina Herwerth Marina Herwerth 1*
  • 1 University Hospital Zürich, Zurich, Switzerland
  • 2 University Hospital of Basel, Basel, Basel-Stadt, Switzerland

The final, formatted version of the article will be published soon.

    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.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.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.

    Keywords: POEMS, Daratumumab, Rapidly progressive Leukoencephalopathy, CD38-Antibody, Toxic leukoencephlaopathy

    Received: 19 Jun 2024; Accepted: 02 Sep 2024.

    Copyright: © 2024 Steinegger, Nierobisch, De Vere-Tyndall, Schreiner, Roth, Kappos, Kana and Herwerth. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Lukas Steinegger, University Hospital Zürich, Zurich, Switzerland
    Marina Herwerth, University Hospital Zürich, Zurich, Switzerland

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