DVd

Say it: D V D

Daratumumab, bortezomib and dexamethasone

DVd is a three medicine plan for multiple myeloma that has come back, combining an antibody (daratumumab), bortezomib shots and a steroid (dexamethasone).

Also called: DVD, Dara-Vd, Dara-Bor-Dex, DBd, daratumumab bortezomib dexamethasone, Darzalex Velcade dexamethasone

What it is

Daratumumab marks myeloma cells so the immune system can destroy them. Bortezomib blocks the protein recycling system inside myeloma cells. Dexamethasone kills myeloma cells directly. After about 6 months, bortezomib and dexamethasone usually stop and daratumumab continues on its own.

Often used for

• multiple myeloma that has come back after at least one earlier treatment

Three medicine phase

Cycles 1 to 8 (about 6 months) use all three medicines in 21 day cycles.

Daratumumab alone phase

From cycle 9 on, daratumumab alone is given every 4 weeks for as long as it works.

Shot vs IV daratumumab

Most people now get daratumumab as a shot under the skin, which takes only a few minutes. The IV form takes several hours.

The medicines in this plan

Daratumumab

Antibody that targets a protein (CD38) on myeloma cells. Given as a shot under the skin over a few minutes, or through a vein over several hours.

Bortezomib

Proteasome inhibitor given as a quick shot under the skin, twice a week for 2 weeks of each 3 week cycle, for 8 cycles.

Dexamethasone

Steroid taken by mouth or through a vein, on the day of and the day after each bortezomib shot.

How you get it

All three medicines are given or started in the clinic. In the first 8 cycles (21 days each), you have visits on days 1, 4, 8 and 11. Daratumumab is weekly in cycles 1 to 3, every 3 weeks in cycles 4 to 8, then every 4 weeks by itself. Your schedule may be different.

A typical cycle

Days 1, 4, 8 and 11 (cycles 1 to 8)

Bortezomib shot, with dexamethasone that day and the next.

Days 12 to 21 (cycles 1 to 8)

Rest from bortezomib. Daratumumab continues on its schedule.

Cycles 1 to 3

Daratumumab once a week.

Cycles 4 to 8

Daratumumab every 3 weeks.

Cycle 9 onward

Daratumumab alone every 4 weeks.

Common side effects and what helps

• Tingling, numbness or burning in the hands and feet from bortezomib. Tell your team early so they can adjust treatment.
• Low platelets, which can cause easy bruising or bleeding. Your team checks your blood.
• Low white blood cell counts and infections. Wash your hands often and stay away from people who are sick.
• Reactions during or after the first daratumumab dose, such as stuffy nose, cough, chills or throat tightness. Medicines are given beforehand to help.
• Diarrhea or constipation. Drink fluids and ask about medicines that help.
• Tiredness. Rest and short walks can help.
• Dizziness when standing up. Stand up slowly.
• Trouble sleeping, mood changes and high blood sugar on dexamethasone days. Take it in the morning with food.

Call your care team right away if you have

• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
• Trouble breathing, wheezing or throat tightness during or after a daratumumab dose
• Bleeding that will not stop, blood in your urine or stool, or many new bruises
• Fainting or feeling like you will pass out
• Numbness or weakness that makes it hard to walk, button clothes or hold things
• Trouble breathing, chest pain, or a fast or pounding heartbeat

Good to know

• You will take an antiviral medicine to prevent shingles. This is important with bortezomib.
• Daratumumab can interfere with blood bank tests. You will have a blood type test before the first dose, and you should tell any hospital that you take it.
• Your team will check for hepatitis B before starting, because daratumumab can wake up an old infection.
• Your team checks your nerves at each visit and may lower the bortezomib dose or switch to weekly shots if numbness gets worse.

At home

• Take your antiviral medicine every day as prescribed.
• Carry a card or note that says you take daratumumab.
• Wear shoes that fit well and check your feet if they feel numb.
• Drink plenty of fluids unless told to limit them.
• Wash your hands often and stay away from people who are sick.

Questions to ask

• Will I get daratumumab as a shot or through a vein?
• When will bortezomib stop?
• What should I do if my hands or feet start to tingle?
• Should I get any vaccines before or during treatment?
• How will we track whether the myeloma is responding?

Multiple myeloma

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.