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The metabolism and elimination of NAD+ (and its by-products) could be altered in advanced hepatic or renal dysfunction, and high-dose NAD+ might theoretically affect cardiovascular dynamics, so practitioners generally avoid or closely supervise NAD+ use in such settings

In radiation studies, daratumumab radiolabeled with lutetium-177 ( 177 Lu) using a DTPA chelator, demonstrated tumor growth reduction and necrosis induction in preclinical lymphoma models [130]