Risk of new alloimmunization in patients on anti-CD38 treatment using tube LISS-IAT method.

Autor: Safić Stanić H; Department of Immunohematology, Croatian Institute of Transfusion Medicine, Zagreb, Croatia. Electronic address: hsafic@gmail.com., Kruhonja Galić Z; Department of Immunohematology, Croatian Institute of Transfusion Medicine, Zagreb, Croatia., Lukić M; Department of Immunohematology, Croatian Institute of Transfusion Medicine, Zagreb, Croatia; Clinical Hospital Merkur, Zagreb, Croatia., Bingulac-Popović J; Department of Molecular Diagnostics, Croatian Institute of Transfusion Medicine, Zagreb, Croatia., Jukić I; Medical Department, Croatian Institute of Transfusion Medicine, Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.
Jazyk: angličtina
Zdroj: Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis [Transfus Apher Sci] 2024 Apr; Vol. 63 (2), pp. 103873. Date of Electronic Publication: 2024 Jan 12.
DOI: 10.1016/j.transci.2024.103873
Abstrakt: Background: Daratumumab is a monoclonal antibody that targets CD38, a transmembrane protein expressed on many cells including RBCs and to a greater extent on myeloma cells. It has been used for treatment of multiple myeloma and autoimmune diseases. Transfusion management of patients on such therapy can be challenging as these drugs cross-react with RBC surface antigens and cause panreactivity.
Material and Methods: A retrospective study of the 68 patients treated with anti-CD38 from 2018-2023 was carried out. Data regarding transfusion history and antibody screens were analyzed. Depending whether they had immunohematological work-up before or during the treatment- DAT, antibody screen (CAT and tube), RBC pheno/genotyping and serologic cross-matches (CAT and tube) were performed for each patient. All cases with positive CAT IAT were retested in LISS-tube and cross-matches were performed with phenotypically matched units in LISS-tube.
Results: Antibody screen has shown panagglutination with all panel cells with low and variable agglutination intensity (weak to 2 +). Panagglutination remained positive for 1 - 6 months after drug cessation. Positive DAT was seen in 60,6% patients, while autocontrol was negative. Ficin treated panel-cells eliminated nonspecific reactivity. LISS-tube antibody screen and cross-matches were negative for all patients, apart from 3 patients who had preexisting antibodies. No new antibodies were detected during the course of the study.
Conclusion: Among study group there were no newly identified alloantibodies, meaning that the policy of transfusing them with matched RBCs and performing IAT/cross-matches in tube is a safe and effective policy according to the findings of this study.
Competing Interests: Conflict of Interest The authors declare no competing interests.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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