There is increasing demand for daratumumab (DARA), a humanized IgG1κ monoclonal antibody to CD38 approved for the treatment of relapsed and/or refractory multiple myeloma (MM). However, DARA interference in indirect antiglobulin tests (IATs) may persist for up to 6 months after discontinuation of DARA. Here, we describe a patient with MM with pan-reactive antibody in an antibody screening test and no history of DARA administration at Osaka University Hospital. We confirmed that the suspected pan-reactive antibody was due to DARA interference based on her medical history of DARA administration in a previous hospital and negated the positive reaction in IATs using the Osaka method (0.01 mol/l DTT).
The patient was a 60-year-old Japanese female who had been suffering from MM. She was referred to Osaka University Hospital for allogeneic bone marrow transplantation following relapse despite treatment at a previous hospital. The antibody screening test performed at admission was positive and pan-reactive. However, there was no indication of any history of DARA administration at our hospital. We tried to obtain her medical history in the previous hospital further and noted that DARA had been administered for 6 months, and that 3 months had elapsed since the discontinuation of DARA. By employing the newly developed Osaka method, we confirmed that the suspected pan-reactive reaction was due to DARA interference. This case report suggests that the Osaka method is easy to perform and effective for negating DARA interference.
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