Effective Neutralization of Daratumumab Effects on Pre-Transfusion Testing: a Method Modification.

Area of Science:

• Transfusion Medicine
• Immunology
• Hematology

Background:

• Daratumumab, an anti-CD38 antibody, is a standard multiple myeloma treatment.
• CD38 expression on erythrocytes causes agglutination in daratumumab-treated patients, complicating pre-transfusion serology.
• Dithiothreitol interferes with erythrocyte antigens, impacting antibody detection.

Purpose of the Study:

• To develop a DARAEx® protocol for the Grifols platform.
• To enable reliable erythrocyte alloantibody detection in daratumumab-treated patients.

Main Methods:

• A modified DARAEx® protocol, termed AssutaBB, was developed.
• Antibody screenings were performed on samples from 19 daratumumab-treated patients using the AssutaBB protocol on the Grifols platform.

Main Results:

• The AssutaBB protocol successfully provided antibody screen results for all tested patients.
• Results were consistent with the manufacturer's default protocol.
• Eleven patients had negative antibody screens, while eight showed positive K/E antibodies.

Conclusions:

• The AssutaBB protocol facilitates the use of the Grifols platform for serological testing in daratumumab-treated patients.
• This advancement improves the safety and efficiency of pre-transfusion testing in this patient population.