A Rare Case of Daratumumab-Associated Encephalopathy in Multiple Myeloma

Abstract

Aim: Daratumumab, a CD38 monoclonal antibody, has been widely used in patients with multiple myeloma. Although a variety of adverse events have been reported, consciousness impairment has not been reported yet. We report a case of encephalopathy associated with daratumumab. Case presentation: A 57-year-old male, diagnosed with relapsed multiple myeloma, was treated with daratumumab. He developed a loss of consciousness after the first administration. Cerebral spinal fluid and magnetic resonance imaging of the brain suggested encephalopathy. Conclusion: It is recommended to be aware of rare but life threatening side effects of daratumumab. We present a case of rare encephalopathy characterized by consciousness disorder associated with daratumumab, which was successfully resolved on prompt institution of steroids, although the mechanism was unknown.

Plain Language Summary

Daratumumab is a drug. It is used to treat multiple myeloma. Many patients use this drug. It has many side effects. But consciousness disorder is rare. A 57-year-old male was diagnosed with multiple myeloma. He was treated with daratumumab. He became unconscious after this treatment. Steroids helped his recovery.

Tweetable abstract

Daratumumab has been widely used for patients with multiple myeloma. We present a case of rare encephalopathy characterized by consciousness disorder associated with daratumumab, which was resolved by steroids, although the mechanism was unknown. #daratumumab #multiple myeloma.

Keywords: :

• adverse event
• consciousness disorder
• daratumumab
• encephalopathy
• methylprednisolone
• multiple myeloma

Author contributions

N Zhu and Z Hong performed medical record writing, Y Zhang performed data analysis, N Zhu and J Xiang wrote the manuscript, J Chen and J Shen approved the version to be published.

Acknowledgments

The authors thank relatives of the patient for their consent to use his data for publication.

Financial disclosure

The present study was supported by the Youth Project of the National Natural Science Foundation of China [Grant No. 81800138] and Zhejiang Provincial Natural Science Foundation of China [Grant No. LTGY23H290001], mainly used for metagenomics next-generation sequencing (mNGS) and paraneoplastic antibodies detection of CSF.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, stock ownership or options and expert testimony.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

Informed consent disclosure

This study has been approved by the Ethics Committee of The First Affiliated Hospital of Zhejiang Chinese Medical University (2022-KL-203). The authors state that they have obtained verbal and written informed consent from the patient/patients for the inclusion of their medical and treatment history within this case report.

Open access

This work is licensed under the Attribution-NonCommercial-NoDerivatives 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0