A MULTI-INSTITUTIONAL COLLABORATIVE STUDY OF PRETRANSFUSION TESTS IN PATIENTS WHO RECEIVED ANTI-CD38 THERAPY

Abstract

Anti-CD38 antibody (Ab) is a human monoclonal antibody for the treatment of multiple myeloma. CD38 is expressed on red blood cells (RBCs), and can interfere with pretransfusion tests. Here, we conducted a nation-wide multi-institutional collaborative study to clarify the interference of anti-CD38 Ab in pretransfusion tests, and investigated the current situation regarding the preparation of RBCs for patients who are treated with anti-CD38 Ab, as well as communication between clinicians and transfusion units on anti-CD38 therapy.

From December 2017 to December 2020, 136 cases were registered from 18 institutions. Information on patients receiving anti-CD38 therapy was provided from clinicians to the transfusion units before pretransfusion tests in 116 cases (85%). In 3 cases, pan-agglutination was observed on Ab screening by the saline method using dithiothreitol (DTT) -treated RBCs, but not observed using DTT-untreated RBCs. In 6 cases, pan-agglutination was observed in Ab screening by the enzyme method after the receipt of anti-CD38 Ab, but not observed before receipt. RBCs were transfused in 65 cases after receiving anti-CD38 Ab. Adverse reactions did not occur in any case. Median time of a clinically relevant delay due to anti-CD38 Ab was 60 minutes (range, 45 minutes-24 hours). Given the increasing use of therapeutic monoclonal Abs for the treatment of cancer and other conditions, unexpected results in pretransfusion tests may become more commonplace.