Serological characteristics and matching strategy of CD38 monoclonal antibody following the treatment of multiple myeloma / 中国输血杂志

ABSTRACT

【Objective】 To understand the serological characteristics of antibodies produced by CD38 monoclonal antibody( mAb) in the treatment of multiple myeloma, solve the daratumumab interference with blood compatibility testing, and formulate the corresponding blood transfusion strategy. 【Methods】 5 patients with multiple myeloma in our hospital after CD38 mAb chemotherapy were observed in terms of the time of the first presence of positive antibody in screening test, the agglutination intensity and titer, the reaction with the newborn red blood cells or not. The 0.2 mol/L DDT was used to treat the antibody screening cells, the panel cells and the donor erythrocytes, and microcolumn gel method was used for crossmatch. 【Results】 After daratumumab chemotherapy, the time of first presence of positive antibodies in identification tests was 24.8 d on average, the antibody strength was between 2+ and 3+, the titer of antibody was between 1/1 024 and 1/4 906, and they did not respond to those newborn red blood cells. After the treatment of red blood cells with DDT, antibody screening, antibody identification and the major crossmatch became negative. The hemoglobin review showed that blood transfusion after blood cross matching was effective. 【Conclusion】 0.2 mol/L DDT could be used to solve the daratumumab interference with blood compatibility, which presents as panreactivity in the antibody screen, and microcolumn gel method can be used to check the results of antibody screening and crossmatch.