Listeria Susceptibility in Patients With Multiple Myeloma Receiving Daratumumab-Based Therapy | Hematology | JAMA Oncology | JAMA Network
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    Research Letter
    November 27, 2019

    Listeria Susceptibility in Patients With Multiple Myeloma Receiving Daratumumab-Based Therapy

    Author Affiliations
    • 1Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
    • 2Department of Infection Prevention and Control, University Health Network, Toronto, Ontario, Canada
    • 3Department of Medicine, University of Toronto, Toronto, Ontario, Canada
    • 4Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
    JAMA Oncol. 2020;6(2):293-294. doi:10.1001/jamaoncol.2019.5098

    Daratumumab is a human immunoglobulin G1κ monoclonal antibody directed against cluster of differentiation (CD) 38 that received US Food and Drug Administration approval in 2017 as multiple myeloma therapy. While CD38 is highly expressed by myeloma cells, it is also expressed by activated macrophages and appears to play an important role in Listeria defense, inhibiting the infection of the macrophage cytoplasm by phagocytosed bacilli and preventing macrophage-based dissemination.1 In mice, CD38 inactivation causes a marked susceptibility to Listeria monocytogenes. As CD38 is also induced on human macrophages, identical mechanisms may underlie human Listeria protection.2

    Clinical trials have characterized daratumumab’s safety profile and demonstrated only a mild infection risk.3 However, because preclinical models of CD38 inactivation are associated with increased L monocytogenes susceptibility, we assessed the risk of listeriosis in patients receiving anti-CD38 daratumumab therapy.