II. Indications

III. Mechanism

  1. CD38 Antigen (Cyclic ADP Ribose Hydrolase)
    1. Cell surface enzyme expressed primarily on WBCs (esp. plasma cells, as well as B Cells, T Cells, Natural Killer Cells)
    2. CD38 catalyzes the reaction catalyzes the synthesis of cyclic ADP-Ribose (cADPR) from NAD+ and ADP-Ribose
      1. Cyclic ADP-Ribose is integral to intracellular Calcium level regulation
    3. CD38 also activates a second messenger system in cell signaling
      1. Appears to regulate cytotoxic response of activated Natural Killer Cells
  2. CD38 Monoclonal Antibody (e.g. Daratumumab)
    1. Monoclonal Antibody directed against the cell surface Glycoprotein CD-38
    2. Used to target Multiple Myeloma and plasma Leukemia cells
    3. Binding triggers anti-tumor cytotoxicity

IV. Medications

  1. Daratumumab (Darzalex) injection solution

V. Dosing

  1. See other references for disease specific dosing protocols
  2. Premedicate with Corticosteroids, antipyretics and Antihistamines

VI. Adverse Effects

  1. Infusion Reactions
  2. Cytopenia
    1. Neutropenia
    2. Thrombocytopenia
  3. Other common adverse effects
    1. Peripheral Neuropathy
    2. Nausea
    3. Altered bowel habits (Constipation, Diarrhea)
    4. Peripheral Edema
    5. Dyspnea

VII. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters, Pregnancy category X)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count with differential and Platelet Count

VIII. Drug Interactions

  1. Interferes with Red Blood Cell cross-matching and Antibody screening
    1. Type and screen prior to treatment

Images: Related links to external sites (from Bing)

Related Studies

Ontology: CD38 Antigen (C0075742)

Definition (CSP) membrane associated enzymes; converts NAD to cyclic ADP ribose; CD (2+) activates second messenger and ADP ribose.
Definition (MSH) A bifunctional enzyme that catalyzes the synthesis and HYDROLYSIS of CYCLIC ADP-RIBOSE (cADPR) from NAD+ to ADP-RIBOSE. It is a cell surface molecule which is predominantly expressed on LYMPHOID CELLS and MYELOID CELLS.
Concepts Amino Acid, Peptide, or Protein (T116)
MSH D051997
SnomedCT 69832000
LNC LP18354-8, LP95517-6, MTHU034406, MTHU022280
English CD38 - Cluster of diff ag 38, Cluster of diff antigen 38, CD38 Antigen, ANTIGENS CD 038, CD 038 ANTIGENS, Antigens, CD38 [Chemical/Ingredient], cd38 antigen, CD38 molecule, CD38 Ag, CD38, Lymphocyte antigen CD38, CD38 - Cluster of differentiation antigen 38, Cluster of differentiation antigen 38, Leucocyte 17, OKT10 - Ortho Kung T10, Ortho Kung T10, T-cell lineage 10, T10 - T-cell lineage 10, Leukocyte 17, Lymphocyte antigen CD38 (substance), Antigen, T10, CD38 Antigens, CD38, ADPR Cyclase, Cyclase CD38, ADPR, Cyclase T10, ADPR, Lymphocyte Differentiation Antigen CD38, NIM R5 Antigen, NIM-R5 Antigen, ADPR Cyclase CD38, ADPR Cyclase T10, Acute Lymphoblastic Leukemia Cells Antigen CD38, T10 Antigen, Antigens, CD38
Czech antigeny CD38
Finnish CD38-antigeenit
Russian ANTIGENY CD38, CD38 ANTIGENY, CD38 АНТИГЕНЫ, АНТИГЕНЫ CD38
Japanese 抗原-CD38, 抗原-T10, CD38抗原, T10抗原
Swedish CD39-antigener
French Antigène CD38 de différentiation des lymphocytes, Cyclic ADP-ribose hydrolase 1, ADP-ribosyl cyclase 1, cADPr hydrolase 1, Antigènes CD38, Antigène CD38, Antigène T10, CD38, ADPR cyclase CD38, ADPR cyclase T10, Antigène CD38 de différentiation lymphocytaire
Polish Antygeny CD38
Spanish antígeno linfocitario CD38 (sustancia), antígeno linfocitario CD38, Antígenos CD38
Portuguese Antígenos CD38
German ADPR-Cyclase CD38, ADPR-Cyclase T10, Antigene, CD38-, CD38-Antigene, CD38-Antigen, Lymphozyten-differenzierendes Antigen CD38, NIM-R5-Antigen, T10-Antigen
Italian Antigeni CD38

Ontology: Cyclic ADP-ribose Hydrolase (C0217585)

Definition (MSH) EC 3.2.2.5
Concepts Amino Acid, Peptide, or Protein (T116) , Enzyme (T126)
MSH D036541
English cADPR hydrolase, ADP-ribose Hydrolase, Cyclic, Cyclic ADP ribose Hydrolase, Hydrolase, Cyclic ADP-ribose, Hydrolase, cADPR, cADPR Hydrolase, Cyclic ADP-ribose Hydrolase
German cADP-Ribose Hydrolase, zyklische-ADP-Ribose Hydrolase, cADPR-Hydrolase

Ontology: daratumumab (C2346801)

Definition (NCI) A fully human monoclonal antibody directed against the cell surface glycoprotein CD-38 with potential antineoplastic activity. The binding of anti-CD38 monoclonal antibody to natural killer (NK) cells mimics the normal CD38-CD31 interaction on the NK cell surface. CD38 is also present on multiple myeloma (MM) cells and plasma leukemia cells; this agent may preferentially bind these cells, triggering antitumoral antibody-dependent cellular cytotoxicity (ADCC) and complement-dependent cytotoxicity (CDC). CD38, a cell surface glycoprotein, is present on various immune cells and has been shown to regulate the cytotoxic response of activated NK cells.
Concepts Pharmacologic Substance (T121)
MSH C556306
English Anti-CD38 Monoclonal Antibody, Daratumumab, daratumumab, JNJ-54767414, DARATUMUMAB