ArticleAnnals of hematology2026
Single low-dose daratumumab enhances rituximab efficacy for sustained remission in treatment-refractory autoimmune cytopenias.
Article in Annals of hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Treatment-refractory autoimmune cytopenias (AIC) including immune thrombocytopenia (ITP), autoimmune hemolytic anemia (AIHA), and Evans syndrome (ES) lack therapies providing durable remission. We conducted a retrospective cohort study of 22 adults with refractory primary AIC who received single low-dose daratumumab (100 mg, day 0) combined with rituximab (100 mg weekly ×4 doses) and glucocorticoids. Primary endpoints were overall response rate (ORR), complete response rate (CRR), relapse-free survival (RFS), and safety. Among participants (median age 63.0 years; 81.8% female), 95.5% achieved initial response (CRR 27.3%; partial response rate 68.2%) with median time-to-response 7 days. At median follow-up 322 days, sustained ORR was 81.8% with CRR 59.1%. with disease-specific rates: CRR/ORR of 60.0%/80.0% (AIHA), 60.0%/70.0% (ITP), and 57.1%/100.0% (ES). Cumulative CRR by subtype were 75% (AIHA), 80% (ITP), and 65.7% (ES) (P = 0.031). The median RFS was not reached during the follow-up period. Averse events occurred in 36.4% of patients, primarily infections (27.8%; herpesvirus, urinary/respiratory tract) and rash (9.1%); all resolved with intervention. In conclusion, this dual-pathway targeting regimen induced rapid, durable hematologic responses in refractory AIC with manageable toxicity. The single low-dose daratumumab approach demonstrates significant clinical feasibility, potentially redefining therapeutic paradigms for antibody-mediated autoimmune disorders.
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