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

Tracy King; Jacqueline Jagger; Jodie Wood; Carmel Woodrow; Alicia Snowden; Sally Haines; Christina Crosbie; Kristen Houdyk

doi:10.4103/apjon.apjon_9_18

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Year : 2018 | Volume : 5 | Issue : 3 | Page : 270-284

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

Tracy King¹, Jacqueline Jagger², Jodie Wood³, Carmel Woodrow⁴, Alicia Snowden⁵, Sally Haines⁶, Christina Crosbie⁷, Kristen Houdyk⁸
¹ Institute of Haematology, Royal Prince Alfred Hospital, Sydney, Australia
² Cancer Services, Gosford Hospital, Gosford, NSW, Australia
³ Cancer Services, Flinders Medical Centre, Adelaide, SA, Australia
⁴ Division of Cancer Services, Princess Alexandra Hospital, Brisbane, QLD, Australia
⁵ Precision Haematology, Melbourne, Australia
⁶ Haematology and Stem Cell Transplantation Service, The Alfred Hospital, Melbourne, Australia
⁷ Haematology, St. Charles Gairdner Hospital, Nedlands WA, Australia
⁸ Cancer Clinical Trials Centre, Austin Health, Melbourne, VIC, Australia

Correspondence Address:
Tracy King
Institute of Haematology, Royal Prince Alfred Hospital, Sydney
Australia

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/apjon.apjon_9_18

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.

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