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Khan S, Vaisman A, Hota SS, et al. Listeria Susceptibility in Patients With Multiple Myeloma Receiving Daratumumab-Based Therapy. 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.
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