II. Indications
III. Mechanism
- CD38 Antigen (Cyclic ADP Ribose Hydrolase)
- Cell surface enzyme expressed primarily on WBCs (esp. plasma cells, as well as B Cells, T Cells, Natural Killer Cells)
- CD38 catalyzes the reaction catalyzes the synthesis of cyclic ADP-Ribose (cADPR) from NAD+ and ADP-Ribose
- Cyclic ADP-Ribose is integral to intracellular Calcium level regulation
- CD38 also activates a second messenger system in cell signaling
- Appears to regulate cytotoxic response of activated Natural Killer Cells
- CD38 Monoclonal Antibody (e.g. Daratumumab)
- Monoclonal Antibody directed against the cell surface Glycoprotein CD-38
- Used to target Multiple Myeloma and plasma Leukemia cells
- Binding triggers anti-tumor cytotoxicity
IV. Medications
- Daratumumab (Darzalex) injection solution
V. Dosing
- See other references for disease specific dosing protocols
- Premedicate with Corticosteroids, antipyretics and Antihistamines
VI. Adverse Effects
- Infusion Reactions
- Cytopenia
- Other common adverse effects
- Peripheral Neuropathy
- Nausea
- Altered bowel habits (Constipation, Diarrhea)
- Peripheral Edema
- Dyspnea
VII. Safety
- Avoid in Lactation
- Avoid in pregnancy (all trimesters, Pregnancy category X)
- Use reliable Contraception
- Monitoring
- Complete Blood Count with differential and Platelet Count
VIII. Drug Interactions
- Interferes with Red Blood Cell cross-matching and Antibody screening
- Type and screen prior to treatment