Adverse reactions related to intravenous daratumumab infusion: a retrospective cohort study

Keywords

multiple myeloma - antibodies monoclonal - drug-related side effects and adverse re

Introduction: Daratumumab is a monoclonal antibody used in the treatment of multiple myeloma, which binds to CD38 proteins, causing the death of cancer cells. It can be used alone or in combination with bortezomib, lenalidomide, or dexamethasone, and its administration can be subcutaneous or intravenous. Despite being a modern and revolutionary treatment, infusion-related reactions have been reported in approximately half of all patients receiving this therapy, mostly during the first infusion and generally of mild to moderate severity. Studies suggest that common symptoms may include respiratory symptoms such as nasal congestion, cough, and throat irritation, as well as chills, vomiting, and nausea. Therefore, administration in escalated doses is used to avoid such side effects.

Objective: To describe the adverse effects related to the infusion reactions of intravenous daratumumab and the measures taken in a chemotherapy outpatient clinic in the Zona da Mata region of Minas Gerais, Brazil.

Method: This is a quantitative, retrospective, observational, and descriptive cohort study of patients exposed to intravenous daratumumab in 2023 in a chemotherapy outpatient clinic. The study was single-center and involved the analysis of medical records and reports generated for adverse events.

Results: Fifteen people participated in this study, eight men and seven women, with an average age of 65 years. Of these patients, nine received their first infusion in 2023, and six had subsequent sessions, totaling 204 infusions throughout the year. Four patients (44%) experienced adverse reactions, all of mild to moderate severity, during the first infusion. Reported reactions included nasal congestion (25%), tremors (25%), throat itching (12.5%), cough (12.5%), headache (12.5%), facial flushing (12.5%), and limb stiffness (12.5%). None of the patients needed to pause treatment due to these reactions, and they were treated at the time of the reaction with hydrocortisone following medical evaluation.

Conclusion: The study corroborates existing literature and highlights the need for continuous monitoring of daratumumab infusions, particularly in first-time patients. Moreover, the creation of a protocol for adverse reactions to chemotherapeutic agents ensures that the entire team can promptly attend to the patient, ensuring safety, prognosis, and quality of treatment.

Corresponding author: Isadora Caldeira Belini (e-mail: [e-mail]).

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
06 May 2025