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Asia Pac J Oncol Nurs. 2018 Jul-Sep;5(3):270-284. doi: 10.4103/apjon.apjon_9_18.

Best Practice for the Administration of Daratumumab in Multiple Myeloma: Australian Myeloma Nurse Expert Opinion.

Author information

Institute of Haematology, Royal Prince Alfred Hospital, Sydney, Australia.
Cancer Services, Gosford Hospital, Gosford, NSW, Australia.
Cancer Services, Flinders Medical Centre, Adelaide, SA, Australia.
Division of Cancer Services, Princess Alexandra Hospital, Brisbane, QLD, Australia.
Precision Haematology, Melbourne, Australia.
Haematology and Stem Cell Transplantation Service, The Alfred Hospital, Melbourne, Australia.
Haematology, St. Charles Gairdner Hospital, Nedlands WA, Australia.
Cancer Clinical Trials Centre, Austin Health, Melbourne, VIC, Australia.


Patients with multiple myeloma (MM) are typically of an advanced age and may have significant co-existing medical conditions. They have often had multiple lines of therapy and as such experience disease-related effects alongside associated treatment toxicities. Daratumumab is a monoclonal antibody approved for the treatment of MM in the relapsed/refractory setting. Clinical studies found that daratumumab showed good tolerability as a monotherapy and in combination with current standard therapies. However, the administration of daratumumab does require specific management considerations. It is administered as an intravenous infusion and infusion-related reactions (IRRs) may occur. Daratumumab also interferes with routine blood transfusion tests, giving false positives for the indirect antiglobulin test. This article highlights key nursing care considerations and practical management aspects to improve the treatment experience of patients receiving daratumumab infusions. Pretreatment aspects, patient education, pre- and post-medication, daratumumab administration, and the management of IRRs are discussed. An IRR management sheet that could be used by nurses and a patient information sheet are located at the end of this article.


Daratumumab; infusion-related reaction; multiple myeloma

Conflict of interest statement

Financial support was provided by Janssen for the authors to attend an advisory board and following discussion at this meeting there was a consensus that local guidelines on the administration of daratumumab should be written. Sally Haines, Jacqueline Jagger, Kristen Houdyk and Alicia Snowden received honoraria from Janssen to attend the advisory board. Tracy King has received honoraria from Amgen (Asia Pacific) and Janssen (India) for lecturing; Amgen, Takeda and Celgene for attendance at conference support. Carmel Woodrow has received sponsorship from Amgen, Celgene and Janssen to attend conferences and workshops. Jacqueline Jagger has received honoraria from Janssen and Amgen and has received travel assistance and accommodation for meetings from Celgene and Novartis.

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