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In addition, Daratumumab reduces the types of inhibitory cells in the TME of multiple myeloma, i.e., it consumes immuno-suppressive cells such as CD38 + MDSCs, Tregs, and Bregs, and enhances anti-tumor activity ( + Treg depletion and induce the proliferation and functional recovery of effector T cells ( Figure 2 )

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References Heffernan MA, et al

Requirements of Vitamin B12 in excess of normal (due to pregnancy, thyrotoxicosis, hemolytic anemia, hemorrhage, malignancy, hepatic and renal disease) can usually be met with oral supplementation