CD38, a type II transmembrane glycoprotein highly expressed in hematological 
malignancies including multiple myeloma (MM), represents a promising target for 
mAb-based immunotherapy. In this study, we describe the cytotoxic mechanisms of 
action of daratumumab, a novel, high-affinity, therapeutic human mAb against a 
unique CD38 epitope. Daratumumab induced potent Ab-dependent cellular 
cytotoxicity in CD38-expressing lymphoma- and MM-derived cell lines as well as 
in patient MM cells, both with autologous and allogeneic effector cells. 
Daratumumab stood out from other CD38 mAbs in its strong ability to induce 
complement-dependent cytotoxicity in patient MM cells. Importantly, 
daratumumab-induced Ab-dependent cellular cytotoxicity and complement-dependent 
cytotoxicity were not affected by the presence of bone marrow stromal cells, 
indicating that daratumumab can effectively kill MM tumor cells in a 
tumor-preserving bone marrow microenvironment. In vivo, daratumumab was highly 
active and interrupted xenograft tumor growth at low dosing. Collectively, our 
results show the versatility of daratumumab to effectively kill CD38-expressing 
tumor cells, including patient MM cells, via diverse cytotoxic mechanisms. These 
findings support clinical development of daratumumab for the treatment of 
CD38-positive MM tumors.