In a retrospective analysis, researchers found that rates of infusion-related reactions (IRRs) with daratumumab in the treatment of multiple myeloma did not increase when premedications were omitted or when the infusion rate was escalated after dose 5. Findings of this analysis were recently reported in the Journal of Hematology Oncology Pharmacy.

The researchers evaluated data from patients with multiple myeloma, amyloid light-chain amyloidosis, or light-chain deposition disease who were treated at Cedars-Sinai Medical Center in Los Angeles, California, with 1 or more cycles of daratumumab. Patients were assigned to 1 of 2 cohorts. In cohort 1, premedications were omitted for patients based on physician’s discretion starting with dose 3 to 5 of daratumumab. In cohort 2, standard premedications were given.

A total of 36 patients were included in cohort 1, and 21 were in cohort 2. With the initial dose of daratumumab, IRRs were reported in 15 patients from cohort 1, and in 8 patients from cohort 2. Following later doses, both groups showed reductions in IRRs, with cohort 1 having 1 patient develop an IRR and cohort 2 having 2 patients with IRRs (P =.5478). This indicated that the omission of premedications did not lead to a significant difference in the rate of IRRs.

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Rapid infusion had been given to 12 patients from cohort 1 following dose 5. None of these patients developed an IRR after the increase in infusion rate. In cohort 2, infusions were given to all patients at rates in accordance with prescribing information for daratumumab.

“By omitting premedications and escalating the infusion rate, we can shorten patients’ time in the infusion area by at least 2 hours and prevent unnecessary side effects from premedications, particularly drowsiness from diphenhydramine, which can interfere with patients’ abilities to drive after treatment,” the researchers wrote in their report. They also indicated that following the results of this analysis, their center adjusted its protocols for daratumumab infusions.


Preedit J, Yudchyts A. Optimizing daratumumab infusion: assessing the safety and feasibility of omitting preinfusion medications and decreasing infusion time. J Hematol Oncol Pharm. 2021;11(1):10-14.

This article originally appeared on Oncology Nurse Advisor