Japanese Journal of Transfusion and Cell Therapy
Online ISSN : 1883-0625
Print ISSN : 1881-3011
ISSN-L : 1881-3011
Case Report
USEFULNESS OF THE ENZYME METHOD IN PATIENTS WITH IRREGULAR ANTIBODIES WHO ARE TREATED WITH DARATUMUMAB
Shinya OhtsukiJunko MichinoRinako AmenoItsuko SatakeRyusuke TomiyamaAkinori WadaJun MurakamiHideki Niimi
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2022 Volume 68 Issue 5 Pages 527-532

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Abstract

Daratumumab (DARA), a human monoclonal antibody which targets CD38 in the treatment of multiple myeloma (MM), can interfere with the indirect antiglobulin test (IAT) due to the weak expression of CD38 on red blood cell (RBC) membranes. To eliminate this interference in pretransfusion testing, RBCs should be treated with DTT. We experienced two cases in which irregular antibodies were identified in patients treated with DARA. In case 1, anti-E was detected on testing for irregular antibodies before DARA administration, which allowed the selection of E antigen-negative RBC in advance of the transfusion test after DARA administration. In case 2, anti-C was detected after transfusion of 8 units of RBCs following receipt of DARA, even though the results of antibody screening were negative before receipt of DARA. A clinically relevant delay in the selection of compatible RBCs can be prevented in cases in which antibody screening and identification is performed before DARA administration, such as in case 1. However, a serious delay in preparing compatible blood may arise in cases in which antibodies are detected following DARA administration, such as in case 2, due to the repeated requirement of DTT treatment of RBCs in pretransfusion testing. The enzyme method may be effective in detecting Rh antibodies, due to the rare interference by DARA in this test.

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© 2022 The Japan Society of Transfusion Medicine and Cell Therapy
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