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In severe cases or when absorption is poor, Vitamin B12 injections are given

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Mechanisms of action Anti-CD38 antibodies exert their therapeutic effects via direct effector mechanisms on MM cells (i.e., CD38 enzymatic inhibition, direct induction of apoptosis) and through Fc-dependent immune mechanisms, including antibody-dependent cellular cytotoxicity (ADCC), complement-directed cytotoxicity (CDC), and antibody-directed cellular phagocytosis (ADCP) (Fig