Considerations for pre-transfusion immunohaematology testing in patients receiving the anti-CD38 monoclonal antibody daratumumab for the treatment of multiple myeloma.

Autor: Quach H; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.; Department of Haematology, St Vincent's Hospital, Melbourne, Victoria, Australia., Benson S; Australian and New Zealand Society of Blood Transfusion, Sydney, New South Wales, Australia., Haysom H; Australian and New Zealand Society of Blood Transfusion, Sydney, New South Wales, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Wilkes AM; Blood Transfusion Laboratory, St Vincent's Hospital, Melbourne, Victoria, Australia., Zacher N; Australian and New Zealand Society of Blood Transfusion, Sydney, New South Wales, Australia.; Clinical Diagnostic Department, Capital Pathology, Canberra, Australian Capital Territory, Australia., Cole-Sinclair M; Department of Haematology, St Vincent's Hospital, Melbourne, Victoria, Australia.; Blood Transfusion Laboratory, St Vincent's Hospital, Melbourne, Victoria, Australia., Miles Prince H; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.; Department of Haematology, Epworth Health, Melbourne, Victoria, Australia., Mollee P; Department of Haematology, Princess Alexandra Hospital, Brisbane, Queensland, Australia., Spencer A; Australian Centre for Blood Diseases, Monash University, Melbourne, Victoria, Australia.; Department of Haematology, Alfred Hospital, Melbourne, Victoria, Australia., Joy Ho P; Department of Haematology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia., Harrison SJ; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.; Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia., Lee C; Department of Haematology, Royal Adelaide Hospital, Adelaide, South Austalia, Australia., Augustson B; Department of Haematology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia., Daly J; Australian and New Zealand Society of Blood Transfusion, Sydney, New South Wales, Australia.; QML Pathology, Brisbane, Queensland, Australia.
Jazyk: angličtina
Zdroj: Internal medicine journal [Intern Med J] 2018 Feb; Vol. 48 (2), pp. 210-220.
DOI: 10.1111/imj.13707
Abstrakt: In recent years, the anti-CD38 monoclonal antibody daratumumab (Darzalex; Janssen-Cilag Pty Ltd) has been shown to be highly efficacious in relapsed and refractory multiple myeloma, with the final results of treatment in newly diagnosed patients awaited. Despite awareness of the potential interference of daratumumab in pre-transfusion immunohaematology testing during phase I and II clinical studies, there was a degree of unpreparedness in the community upon the introduction of this drug into the clinics, particularly the impact that it has on the operational processes in hospital transfusion laboratories and timely issue of red blood cells (RBCs). Anti-CD38 interference in pre-transfusion immunohaematology tests is a particular problem in patients being treated with daratumumab for multiple myeloma as many will require RBC transfusions during their disease treatment. Panagglutination caused by anti-CD38 monoclonal antibody during the indirect antiglobulin test may mask the presence of a clinically significant RBC alloantibody in the patient's plasma during the antibody screen and identification process, which may be overlooked, particularly in urgent situations, subsequently resulting in a delayed or acute haemolytic transfusion reaction. Here, we summarise daratumumab's effects on pre-transfusion immunohaematology testing and its impact on clinical practice and make practical recommendations based on a consensus from medical and scientific transfusion experts and myeloma specialists on behalf of the Australian and New Zealand Society of Blood Transfusion and Myeloma Scientific Advisory Group to Myeloma Australia, respectively.
(© 2018 Royal Australasian College of Physicians.)
Databáze: MEDLINE
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