Sarcoid-like Pulmonary Lesion in a Female Patient with Multiple Myeloma and Systemic AL Amyloidosis Treated with Daratumumab: A Case of Spontaneous Regression of Lung Tissue Changes upon Drug Withdrawal

Sarcoid-like drug reaction is a granulomatous inflammation having clinical and morphological similarity with sarcoidosis and developing as a rule on chemo/immunotherapy. An important characteristic of the drug-induced sarcoid-like reaction consists in its time relationship with a drug assignment and also with a regression upon its withdrawal. Sarcoid-like reactions are known to occur on therapy with immune checkpoint inhibitors, interferons, tumor necrosis factor-alpha antagonists, antiretroviral drugs, BRAF inhibitors, and rituximab. However, no reports have been published on a sarcoid-like reaction associated with the monoclonal anti-CD38 therapy despite a wide experience in their use for treating plasma cell neoplasms. This paper reports the first case of sarcoid-like reaction characterized by pulmonary lesions with confluent large-nodular areas that developed on daratumumab maintenance therapy in a female patient with multiple myeloma and systemic AL amyloidosis. This case report proves the probability of a sarcoid-like reaction on daratumumab therapy. Further studies are necessary to understand the pathogenesis of similar reversible damage.

• Irina Germanovna Rekhtina National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167 ; ФГБУ «НМИЦ гематологии» Минздрава России, Новый Зыковский пр-д, д. 4, Москва, Российская Федерация, 125167 https://orcid.org/0000-0001-5440-4340 (unauthenticated)
• V.A. Khyshova National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167 ; ФГБУ «НМИЦ гематологии» Минздрава России, Новый Зыковский пр-д, д. 4, Москва, Российская Федерация, 125167 https://orcid.org/0000-0002-1008-5007 (unauthenticated)
• A.M. Kovrigina National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167 ; ФГБУ «НМИЦ гематологии» Минздрава России, Новый Зыковский пр-д, д. 4, Москва, Российская Федерация, 125167 https://orcid.org/0000-0002-1082-8659 (unauthenticated)
• M.A. Silaev National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167 ; ФГБУ «НМИЦ гематологии» Минздрава России, Новый Зыковский пр-д, д. 4, Москва, Российская Федерация, 125167 https://orcid.org/0009-0003-6759-0447 (unauthenticated)
• L.P. Mendeleeva National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167 ; ФГБУ «НМИЦ гематологии» Минздрава России, Новый Зыковский пр-д, д. 4, Москва, Российская Федерация, 125167 https://orcid.org/0000-0002-4966-8146 (unauthenticated)

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