An anti-CD38 antibody
Daratumumab
A targeted antibody for multiple myeloma, given by drip or injection by oncology teams.
What is Daratumumab?
Daratumumab is a targeted cancer medicine (a monoclonal antibody) used to treat multiple myeloma, a cancer of plasma cells in the bone marrow. It is given by a specialist oncology team as a drip into a vein or as an injection under the skin, often with other myeloma medicines. It targets a protein called CD38 on the cancer cells. Infusion reactions can happen, especially with the first dose, and it raises the risk of infections. Importantly, it can interfere with blood-group cross-matching tests, so the lab must be told you are on it.
Education and reference only. This is a plain-language guide to Daratumumab — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Daratumumab is a monoclonal antibody, a laboratory-made protein that targets CD38, a marker found in large amounts on myeloma plasma cells. It is used to treat multiple myeloma, usually combined with other myeloma treatments. It is not a tablet; it is given by oncology specialists as a drip into a vein or, more often now, as an injection under the skin. The brand name is Darzalex.
How it works
Myeloma is a cancer of plasma cells, a type of white blood cell in the bone marrow, and these cells carry a lot of a marker called CD38 on their surface. Daratumumab locks onto CD38 and flags the myeloma cells so the immune system attacks and destroys them, and it can also harm the cells directly. It is usually combined with other myeloma medicines, which work in different ways, to control the disease more effectively. Because CD38 is also present on some red blood cells, daratumumab can interfere with the laboratory tests used to match blood for transfusion.
Company & origin
Originated / developed by: Janssen.
A targeted cancer antibody used in the UK by oncology teams to treat multiple myeloma, a cancer of bone marrow plasma cells.
Practical use
How to take Daratumumab
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given by your oncology team as a drip into a vein or an injection under the skin, often with other myeloma medicines; it is never a tablet.
- You will be given supportive medicines before and sometimes after treatment to reduce reactions, and the first drips are given slowly.
- Make sure the laboratory and any hospital know you are on daratumumab, as it affects blood cross-matching tests; carry any card you are given.
- Report signs of infection such as fever, chills, sore throat or a cough promptly, as your infection risk is higher.
- Attend regular blood tests so your blood counts and response to treatment can be monitored.
Weighing it up
Advantages & disadvantages of Daratumumab
Advantages
- Specifically targets CD38 on myeloma cells and helps the immune system destroy them.
- Can be given as a quicker injection under the skin as well as a vein drip.
- Combined with other myeloma medicines, it can control the disease more effectively.
Disadvantages
- Infusion reactions are common, especially with the first dose, so early treatments take longer.
- Raises the risk of infections and can lower blood counts, needing regular checks.
- Interferes with blood cross-matching tests, so the laboratory must be informed.
Practical use
Good to know
A practical point that matters a great deal is that daratumumab interferes with the cross-matching tests used to find safe blood for transfusion, so it is important that the laboratory and any hospital you attend know you are receiving it; you may be given a card to carry. Infusion reactions are common, especially with the first dose, so the first treatments are given slowly with supportive medicines and close watching. It increases the risk of infections, so report fever, chills, a cough or feeling generally unwell promptly, and your team may give preventive treatments, including against shingles. Blood counts are checked regularly, as it can lower white cells, red cells and platelets. It is also worth having any needed vaccinations discussed with your team.
Who should not take it / use with caution
- Anyone who has had a serious allergic reaction to daratumumab should not receive it again.
- It is used with extra care in people with significant breathing problems, such as severe asthma or COPD.
- It is avoided in pregnancy because it may harm the developing baby, so effective contraception is advised.
Monitoring
- Regular blood tests to check blood counts and how the myeloma is responding.
- Close watching for infusion reactions, especially with the first treatments.
- Watching for infections and giving preventive treatment, with the laboratory informed for blood matching.
Side effects
- Infusion reactions such as chills, fever, a blocked or runny nose, cough and breathlessness, mainly early on.
- A higher risk of infections; report fever, chills or feeling unwell promptly.
- Lower blood counts (white cells, red cells and platelets), tiredness, and back or joint aches.
Key interactions
- Given as a planned combination with other myeloma medicines rather than an accidental interaction.
- It interferes with blood cross-matching tests, so the laboratory must know before any transfusion.
- Tell your team about all your medicines, and discuss any vaccinations before having them.
Available as: Given by oncology teams as a drip into a vein or an injection under the skin.
Answers
Daratumumab: frequently asked questions
Why does the laboratory need to know I am on daratumumab?
Daratumumab can interfere with the tests used to match blood for transfusion, so the laboratory and any hospital must know you are on it; you may be given a card to carry.
What is daratumumab used for?
It is used to treat multiple myeloma, a cancer of plasma cells in the bone marrow, usually combined with other myeloma medicines to control the disease.
Why is the first treatment given so slowly?
Infusion reactions are most likely with the first dose, so it is given slowly with supportive medicines and close watching to keep you safe and comfortable.
Will it make me more prone to infections?
Yes, it can raise your infection risk, so report fever, chills or a cough promptly; your team may give preventive treatments and discuss vaccinations.
Is it a drip or an injection?
It can be given either way: as a drip into a vein or, more often now, as an injection under the skin, which is quicker; your team will explain which you are having.
Authoritative sources
- BNF
- NICE CKS
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