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Lin MH, Liu FY, Wang HM, et al. Interference of daratumumab with pretransfusion testing, mimicking a high-titer, low avidity like antibody. Asian J Transfus Sci. 2017;11(2):209-211doi: 10.4103/0973-6247.214358.
Lin, M. H., Liu, F. Y., Wang, H. M., Cho, H. C., & Lo, S. C. (2017). Interference of daratumumab with pretransfusion testing, mimicking a high-titer, low avidity like antibody. Asian journal of transfusion science, 11(2), 209-211. https://doi.org/10.4103/0973-6247.214358
Lin, Mei-Hwa, et al. "Interference of daratumumab with pretransfusion testing, mimicking a high-titer, low avidity like antibody." Asian journal of transfusion science vol. 11,2 (2017): 209-211. doi: https://doi.org/10.4103/0973-6247.214358
Lin MH, Liu FY, Wang HM, Cho HC, Lo SC. Interference of daratumumab with pretransfusion testing, mimicking a high-titer, low avidity like antibody. Asian J Transfus Sci. 2017 Jul-Dec;11(2):209-211. doi: 10.4103/0973-6247.214358. PMID: 28970695; PMCID: PMC5613434.
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Asian J Transfus Sci. 2017 Jul-Dec;11(2):209-211. doi: 10.4103/0973-6247.214358.

Interference of daratumumab with pretransfusion testing, mimicking a high-titer, low avidity like antibody.

Asian journal of transfusion science

Mei-Hwa Lin, Fei-Yun Liu, Hsiu-Mien Wang, Hsin-Ching Cho, Shyh-Chyi Lo

Affiliations

  1. Department of Laboratory Medicine, Division of Transfusion and Transplantation, National Taiwan University Hospital, Taipei, Taiwan.
  2. Department of Laboratory Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.

PMID: 28970695 PMCID: PMC5613434 DOI: 10.4103/0973-6247.214358

Abstract

Daratumumab is a monoclonal immunoglobulin against CD38 and has been approved for treating patients with refractory multiple myeloma. The presence of daratumumab in the sera can interfere with pretransfusion testing due to the weakly expression of CD38 on red cells. The reactivity could be mistaken as autoantibody (if autocontrol is positive) or alloantibody (if autocontrol is negative). We present a case that demonstrates daratumumab could mimic a high titer low avidity (HTLA) alloantibody. A 34-year-old male patient of refractory myeloma was recruited in phase three clinical trial involving daratumumab. Samples were sent to the blood bank for pretransfusion testing. Without knowledge of patient having used daratumumab, we mistook the reactivity in the patient's sera as an HTLA antibody due to the results of negative autocontrol and high titers of antibody activity. Antibody screen showed a panreactive pattern and the reactivity against screening cells was up to a titer of 1: 1240. The reactivity was weaker against cord cells than adult cells, became weaker against ZZAP-treated cells and became negative against DDT-treated cells. A discussion with attending physician finally revealed the reactivity was due to the interference caused by daratumumab. The case demonstrates good communication is essential in performing pretransfusion testing for patients receiving daratumumab and other new biological regimens that can interfere with compatibility test.

Keywords: Antibody screen; daratumumab; pretransfusion testing

Conflict of interest statement

There are no conflicts of interest.

References

  1. Transfusion. 2015 Jun;55(6 Pt 2):1555-62 - PubMed
  2. Transfusion. 2015 Nov;55(11):2770 - PubMed
  3. Transfus Apher Sci. 2009 Jun;40(3):205-7 - PubMed
  4. Transfus Med Rev. 1989 Apr;3(2):128-39 - PubMed
  5. Transfusion. 2016 Mar;56(3):778-9 - PubMed
  6. Blood Rev. 2010 Jul-Sep;24(4-5):143-50 - PubMed
  7. Curr Opin Hematol. 2016 Nov;23 (6):557-562 - PubMed
  8. Transfusion. 2015 Sep;55(9):2292-3 - PubMed
  9. Transfusion. 2015 Jun;55(6 Pt 2):1545-54 - PubMed
  10. Blood. 2016 Feb 11;127(6):681-95 - PubMed

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