Vincent Rajkumar: Stopping All Premeds After Cycle 1 for Both IV and SQ Dara
Vincent Rajkumar, Professor of Medicine at the Mayo Clinic in Rochester, shared a post by Hematologist Lisa Lyons on X:
“We stop all premeds (steroids, antihistamines, and acetaminophen) after cycle 1 for both IV and SQ dara.
If someone has had reactions with even the last dose of cycle 1, then for that patient, these may be continued, but otherwise no. Here is a paper on our experience.
2) Same DVT prophylaxis as you would do for Rev in any situation. No difference with or without Dex.”
“Impact of Premedication De-Escalation on Incidence of Infusion-Related Reactions With Daratumumab”
Authors: Donna Vazirnia, Alejandro Del Rio Verduzco, Scott A. Soefje, Kristyn A. Sanders, Tyler B. Sandahl
Quoting Lisa Lyons‘ post:
“For those reducing dexamethasone in patients on DRd or Dara monotherapy, do you stop Dex pre-meds before Daratumumab? Have you seen increased infusion reactions? And for DRd, what thromboprophylaxis do you use if Dex is reduced/stopped?”
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