A34 DARATUMUMAB DOSE DEPENDENT LIVER INJURY. (1st March 2018)

• Record Type: Journal Article
• Authors: Altuwaijri, M; Lam, E
• Is Part Of: Journal of the Canadian Association of Gastroenterology. Volume 1(2018)Supplement 1
• Page Start: 61
• Page End: 61
• Publication Date: 2018-03-01
• Subjects: Gastroenterology -- Periodicals; 616.33005
• DOI: 10.1093/jcag/gwy008.035
• Languages: English
• ISSNs: 2515-2084

Abstract

Abstract: Background: Daratumumab is a recent addition in the treatment of multiple myeloma (MM). Daratumumab is a human monoclonal antibody directed against CD38. Daratumumab has no major side effects on the liver published to date. In this case report we describe a dose dependent drug induced liver injury after the use of daratumumab in the treatment of MM that has not been described previously. Aims: To describe the first case report of Daratumumab dose dependent liver injury. Methods: Case report Results: A 58-year-old gentleman with IgA kappa MM which was diagnosed in January 2015 and has been refractory to three previous lines of therapy. He was admitted on an outpatient basis to the hospital in August 2016, for the treatment of his refractory IgA kappa MM, with Daratumumab. He had no recent changes in his medications and his baseline liver enzyme profile was normal. Following Daratumumab first full dose with 16mg/kg, the patient became fatigued within 48 hours and there was elevation in liver enzymes with an initial ALT of 1622 and AST of 1672. His Alkaline phosphates was 96 and total Bilirubin was 21. Viral serology (A, B, C, EBV and CMV), Acetaminophen and Ethanol level, Anti-nuclear antibody, anti-mitochondrial antibody and anti-smooth muscle antibody were negative. The dramatic increase in his liver enzymes was attributed to Daratumumab hepatotoxicity. Two days following the first dose, the liver enzymes started to trend down without intervention and gradually decreased to normal level after a period of 20 days. Subsequent doses of Daratumumab were modified at 8 mg/kg without increase in liver enzymes. Conclusions: Daratumumab has a potential hepatotoxic effect that is likely dose dependent. Modified doses of Daratumumab may reduce the risk of liver injury. Funding Agencies: None