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Daratumumab: Therapeutic asset, biological trap!
Summary
Dithiotreitol (DTT) effectively removes daratumumab interference in pre-transfusion tests for myeloma patients. This method enhances blood compatibility testing, ensuring safer transfusions for patients receiving daratumumab therapy.
Area of Science:
- Hematology
- Immunology
- Transfusion Medicine
Background:
- Daratumumab, an anti-CD38 antibody, is used in myeloma treatment.
- CD38 expression on erythrocytes causes daratumumab interference in blood testing.
- This interference complicates the selection of compatible blood for transfusion.
Purpose of the Study:
- To evaluate the efficacy of Dithiotreitol (DTT) in mitigating daratumumab interference in pre-transfusion tests.
- To establish optimized laboratory practices for blood compatibility testing in patients treated with daratumumab.
Main Methods:
- Studied 14 patients undergoing daratumumab therapy, with 11 receiving transfusions.
- Applied Dithiotreitol (DTT) treatment to red blood cells to inhibit daratumumab interference during antibody screening and cross-matching.
- Implemented precautionary measures including pH and storage condition control.
Main Results:
- DTT treatment successfully inhibited daratumumab interference in 13 out of 14 patients.
- Extended phenotyping/genotyping served as an additional safety measure.
- A decisional flow chart was developed to streamline laboratory practices.
Conclusions:
- DTT treatment is a highly effective method for pre-transfusion testing in patients receiving daratumumab.
- This approach improves blood selection safety and ethics compared to relying solely on extended pheno/genotyping.
- Clear protocols and physician collaboration are crucial for quality assurance in transfusion practices.
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