daratumumab at a glance
Medicine class
Anti-CD38 monoclonal antibody
Main licensed uses
Multiple myeloma; selected subcutaneous uses include high-risk smouldering multiple myeloma and systemic AL amyloidosis
How it is given
By a healthcare professional as an abdominal injection under the skin or a diluted intravenous infusion
Blood transfusions
It can interfere with compatibility testing, so transfusion laboratories must know about current or recent treatment
What is daratumumab used for?
The formulations have different licensed uses.
Multiple myeloma in adults, either alone in specified relapsed and refractory disease or with other anti-myeloma treatments in newly diagnosed or previously treated disease.
High-risk smouldering multiple myeloma in adults: licensed as subcutaneous monotherapy.
Newly diagnosed systemic light-chain (AL) amyloidosis in adults: subcutaneous daratumumab combined with cyclophosphamide, bortezomib and dexamethasone.
The intravenous formulation is licensed for specified multiple-myeloma settings, but not for these smouldering-myeloma or AL-amyloidosis indications.
How does daratumumab work?
Daratumumab attaches to CD38 on abnormal plasma cells. It can directly affect these cells and recruit parts of the immune system to destroy them. In AL amyloidosis, reducing the abnormal plasma-cell clone reduces production of harmful light chains.
daratumumab preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 20 mg/mL
Injection
Route: Parenteral
Strengths: 1800 mg
How to take daratumumab
Trained healthcare staff administer daratumumab. The subcutaneous solution is injected into the abdomen, rotating sites and avoiding red, bruised, tender, hard or scarred skin. The intravenous concentrate must be diluted before infusion.
A corticosteroid, antihistamine and antipyretic may be given around treatment to reduce administration-related reactions.
Tell staff promptly about cough, throat irritation, wheeze, chills, nausea, chest discomfort, itching, dizziness or vision changes during or after administration.
Take prescribed medicines intended to prevent delayed reactions or infections as directed by the treatment team.
daratumumab side effects
Common or expected effects
- Administration-related symptoms such as cough, blocked nose, throat irritation, chills, nausea or fever
- Respiratory, urinary or other infections
- Reduced neutrophils, platelets or red blood cells
- Tiredness or weakness
- Diarrhoea, constipation, nausea, vomiting or abdominal discomfort
- Muscle, joint or back pain; tingling or numbness in the hands or feet
- Peripheral swelling
- Redness or rash at a subcutaneous injection site
Get urgent medical advice
- Severe allergic or administration-related reaction, including breathing difficulty, throat swelling, marked blood-pressure change or collapse
- Serious infection, including pneumonia or sepsis
- Severe neutropenia or thrombocytopenia with infection or bleeding
- Hepatitis B reactivation
- Pulmonary oedema, serious heart-rhythm disturbance or fainting
- Sudden eye pain, blurred vision or another acute visual change
daratumumab in pregnancy
Pregnancy data are absent or limited, so daratumumab is not recommended during pregnancy. Discuss contraception and pregnancy plans with the specialist team before treatment. Effective contraception is advised during treatment and for three months afterwards.
daratumumab while breastfeeding
It is unknown whether daratumumab passes into human milk, and risk to a breastfed infant cannot be excluded. The specialist team should weigh the benefit of breastfeeding against the need for treatment.
daratumumab interactions
Formal interaction studies are limited. Conventional liver-enzyme interactions are not expected, but combination treatment can cause overlapping toxicity.
Lenalidomide, pomalidomide, thalidomide, bortezomib and other licensed treatment partners
No clinically relevant pharmacokinetic interaction was found, but each combination treatment retains its own interactions and safety requirements.
Myelosuppressive anti-cancer medicines
Daratumumab may worsen treatment-related neutropenia or thrombocytopenia, increasing the need for blood-count monitoring.
Common questions about daratumumab
Answers are fully visible for fast scanning and source review.
Is daratumumab chemotherapy?
It is a targeted monoclonal antibody rather than conventional cytotoxic chemotherapy, although it is often combined with chemotherapy or other anti-myeloma treatments.
Can reactions start after leaving hospital?
Yes. Delayed reactions can occur. Report cough, wheeze, throat tightness, breathing difficulty, chills, rash, dizziness or vision changes promptly.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.