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Daratumumab in pediatric relapsed/refractory acute lymphoblastic leukemia or lymphoblastic lymphoma: the DELPHINUS study

  • Teena Bhatla
  • , Laura E. Hogan
  • , David T. Teachey
  • , Francisco Bautista
  • , John Moppett
  • , Pablo Velasco Puyó
  • , Concetta Micalizzi
  • , Claudia Rossig
  • , Neerav Shukla
  • , Gil Gilad
  • , Franco Locatelli
  • , André Baruchel
  • , C. Michel Zwaan
  • , Natalie S. Bezler
  • , Alba Rubio-San-Simón
  • , David C. Taussig
  • , Elizabeth A. Raetz
  • , Zhengwei J. Mao
  • , Brent L. Wood
  • , Diana Alvarez Arias
  • Maria Krevvata, Ivo Nnane, Nibedita Bandyopadhyay, Lorena Lopez Solano, Robyn M. Dennis, Robin Carson, Ajay Vora
  • Saint Barnabas Medical Center
  • University of Pennsylvania
  • Princess Máxima Center for Pediatric Oncology
  • Hospital Infantil Universitario Nino Jesus de Madrid
  • University Hospitals Bristol and Weston NHS Foundation Trust
  • University Hospital Vall d'Hebron
  • IRCCS Istituto Giannina Gaslini - Genova
  • University of Münster
  • Memorial Sloan-Kettering Cancer Center
  • Schneider Childrens Medical Center Israel
  • Tel Aviv University
  • Catholic University of the Sacred Heart
  • Hopital Universitaire Robert Debre-APHP
  • Erasmus University Rotterdam
  • University of Connecticut
  • Royal Marsden NHS Foundation Trust
  • New York University
  • University of Washington
  • Johnson & Johnson
  • Great Ormond Street Hospital for Children NHS Foundation Trust

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

Patients with relapsed/refractory acute lymphoblastic leukemia (ALL) or lymphoblastic lymphoma (LL) have poor outcomes compared with newly diagnosed, treatment-naïve patients. The phase 2, open-label DELPHINUS study evaluated daratumumab (16 mg/kg IV) plus backbone chemotherapy in children with relapsed/refractory B-cell ALL (n = 7) after ≥2 relapses, and children and young adults with T-cell ALL (children, n = 24; young adults, n = 5) or LL (n = 10) after first relapse. The primary end point was complete response (CR) in the B-cell ALL (end of cycle 2) and T-cell ALL (end of cycle 1) cohorts, after which patients could proceed off study to allogeneic hematopoietic stem cell transplant (HSCT). Seven patients with advanced B-cell ALL received daratumumab with no CRs achieved; this cohort was closed because of futility. For the childhood T-cell ALL, young adult T-cell ALL, and T-cell LL cohorts, the CR (end of cycle 1) rates were 41.7%, 60.0%, and 30.0%, respectively; overall response rates (any time point) were 83.3% (CR + CR with incomplete count recovery [CRi]), 80.0% (CR + CRi), and 50.0% (CR + partial response), respectively; minimal residual disease negativity (<0.01%) rates were 45.8%, 20.0%, and 50.0%, respectively; observed 24-month event-free survival rates were 36.1%, 20.0%, and 20.0%, respectively; observed 24-month overall survival rates were 41.3%, 25.0%, and 20.0%, respectively; and allogeneic HSCT rates were 75.0%, 60.0%, and 30.0%, respectively. No new safety concerns with daratumumab were observed. In conclusion, daratumumab was safely combined with backbone chemotherapy in children and young adults with T-cell ALL/LL and contributed to successful bridging to HSCT. This trial was registered at www.clinicaltrials.gov as NCT03384654.

Original languageEnglish
Pages (from-to)2237-2247
Number of pages11
JournalBlood
Volume144
Issue number21
DOIs
StatePublished - Nov 21 2024

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