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Abstract: Objective: Daratumumab is a promising new antimyeloma agent. We report a single center “real‐world” series of multiple myeloma (MM) and amyloidosis (AL) patients treated with daratumumab. Methods: Forty‐one patients were included: 7 second‐line MM, 30 heavily pretreated (median number of therapies of 5) advanced MM, and 4 with AL. Results: Second‐line patients and advanced AL showed high rate of durable overall responses. However, advanced MM patients had a dismal prognosis with an overall response rate (ORR) of 36%, and a short median progression‐free and overall survival of 2.3 and 6.6 months, respectively. Responses were particularly poor in patients with extramedullary plasmacytomas. Neither the addition of another agent to daratumumab nor changing to the next line of therapy produced significant durable responses in this patient population. Flow cytometry analysis demonstrated that CD38 expression level was not predictive of response. We show that CD38 expression dynamics by a commercially available anti‐CD38 antibody after daratumumab administration was hindered by competitive binding of daratumumab. Conclusions: Responses to daratumumab and combinations in patients with advanced MM, particularly with extramedullary disease, are low and short‐lived, stressing the administration of this agent should be early in the course of the disease. [ABSTRACT FROM AUTHOR]

The association between NEC and blood transfusion has been extensively discussed in the literature, focusing on the transfusion of packed RBCs. Comparison of outcomes of group O vs non-group O premature neonates receiving group O RBC transfusions. [Extracted from the article]

Hemophagocytic syndrome (HPS) is an unusual acute syndrome presenting with fever, hepatosplenomegaly, and cytopenias. The hallmark of HPS is the accumulation of activated macrophages that engulf hematopoietic cells in the reticuloendothelial system. Most cases of HPS in adults are secondary to infection or malignancy, and thus investigation of the underlying disease is necessary. We describe a patient with prolonged fever, HPS, and chromosomal abnormalities in the bone marrow who underwent thorough evaluation for the cause of his symptoms. A final diagnosis of acute lymphoblastic leukemia (ALL) was established in a fourth, repeated bone marrow biopsy performed more than 2 months after the first presenting symptom appeared. This unusual case demonstrates the importance of cytogenetic abnormalities found in cases of HPS and the importance of repeated testing when an underlying disease is suspected., (Copyright 2004 Wiley-Liss, Inc.)

A 64-year-old woman with chronic myelogenous leukemia (CML) was admitted due to prolonged fever and lung infiltrates. An open lung biopsy was required to make the diagnosis of pulmonary alveolar proteinosis (PAP) and infection with Mycobacterium kansasii. She was treated successfully with combined antimycobacterial therapy for 14 months. However, the leukemia progressed and the patient developed recurrent bilateral lung infiltrates. Blood and bronchoalveolar fluid cultures yielded growth of Acinetobacter. She died shortly thereafter due to septic shock. The relationship between M. kansasii infection, PAP, and abnormal host defense in CML is discussed., (Copyright 2003 Wiley-Liss, Inc.)