Impact of new myeloma agents on the transfusion laboratory

Jones, Andrew D.; Moayeri, Morvarid; Nambiar, Ashok

doi:10.1016/j.pathol.2021.01.001

Cited by 8 publications

(12 citation statements)

References 68 publications

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“…29 Antiidiotype antibody and soluble recombinant CD38 are also reported to prevent binding of daratumumab with CD38-expressing reagent RBCs; 9 however, although the cost of reagent is minimal, this method is expensive and, like DTT, encumbered by an absence of resources not routinely available at many hospital blood banks. 9,16,30,31 In conclusion, the current study shows that both isatuximab and daratumumab interfere with IATs but at different magnitudes in vitro and in vivo, reflecting distinct binding to CD38. In in vitro binding studies, CD38 expressed by RBCs can be directly recognized by daratumumab, whereas isatuximab requires a co-factor, such as a mouse anti-CD38 antibody (HB-7 or AT13/5) or a CD38 inhibitor, suggesting that the isatuximab epitope on RBCs is masked.…”

Section: Isatuximab Interference In the Clinical Settingmentioning

confidence: 59%

“…Other methods of avoiding anti‐CD38 interference include the use of trypsin, a proteolytic enzyme that decreases daratumumab binding to CD38‐expressing cells, but it is not as extensively used as DTT 29 . Anti‐idiotype antibody and soluble recombinant CD38 are also reported to prevent binding of daratumumab with CD38‐expressing reagent RBCs; 9 however, although the cost of reagent is minimal, this method is expensive and, like DTT, encumbered by an absence of resources not routinely available at many hospital blood banks 9,16,30,31 …”

Section: Discussionmentioning

confidence: 99%

“… 29 Anti‐idiotype antibody and soluble recombinant CD38 are also reported to prevent binding of daratumumab with CD38‐expressing reagent RBCs; 9 however, although the cost of reagent is minimal, this method is expensive and, like DTT, encumbered by an absence of resources not routinely available at many hospital blood banks. 9 , 16 , 30 , 31 …”

Section: Discussionmentioning

confidence: 99%

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Anti‐CD38 monoclonal antibody interference with blood compatibility testing: Differentiating isatuximab and daratumumab via functional epitope mapping

et al. 2022

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Background: There are two FDA-approved anti-CD38 monoclonal antibodies for treatment of multiple myeloma: isatuximab and daratumumab. Owing to expression of CD38 on reagent red blood cells (RBCs), these antibodies interfere with indirect antiglobulin tests (IATs). We sought to understand differences in such interference by performing binding experiments. Study Design and Methods: In vitro experiments to compare the binding to RBCs of isatuximab and daratumumab alone or in the presence of a mouse anti-human CD38 antibody (HB-7 or AT13/5) or a nicotinamide adenine dinucleotide-analog CD38 inhibitor were performed and quantified by flow cytometry, imaging, mass spectrometry, surface plasmon resonance, and LigandTracer technologies. Serologic testing was performed on plasma samples spiked with isatuximab or daratumumab. Results: CD38 expressed on RBCs can be directly bound by daratumumab, whereas isatuximab requires a co-factor, such as HB-7, AT13/5, or a CD38

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Section: Isatuximab Interference In the Clinical Settingmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Anti‐CD38 monoclonal antibody interference with blood compatibility testing: Differentiating isatuximab and daratumumab via functional epitope mapping

et al. 2022

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“…In recent years, CD47 as a novel therapeutic target, has become a research hotspot for the treatment of hematological diseases and solid tumors by blocking the CD47-SIRPα signaling pathway through anti-CD47 antibodies and promoting phagocytosis of macrophages to remove tumor cells [7,8] . A variety of anti-CD47 antibodies have entered the clinical trial stage at China and abroad [9][10][11] , such as: Gilead's Hu5F9-G4, a monoclonal Immunoglobulin G4 (IgG4) antibody, has certain blood toxicity; Kang Fang independently developed a new generation of CD47 monoclonal antibody AK117 (IgG4 antibody), the current clinical trials have confirmed that AK117 has more outstanding safety advantages and strong phagocytic activity than other CD47 monoclonal antibody. Since CD47 is also expressed on red blood cells and platelets, treatment with CD47 monoclonal antibody is not only likely to cause anemia and thrombocytopenia, but also interfere with the results of transfusion compatibility testing [9] .…”

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confidence: 99%

The Interference of Monoclonal Anti-Cluster of Differentiation 47 on Transfusion Compatibility Testing

Xu¹,

Ni²,

Chen³

2023

IJPS

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Hu5F9-G4 and AK117, novel cluster of differentiation 47 blockers, are used to treat solid tumors and hematoma. Because cluster of differentiation 47 is expressed on erythrocytes, treatment with monoclonal anti-cluster of differentiation 47 may interfere with the results of transfusion compatibility testing. This study analyzed the interference and treatment of Hu5F9-G4 and AK117 on transfusion compatibility testing. Saline and microcolumn gel methods were used to identify the blood types of the patients. To screen irregular antibodies, salt water, indirect antiglobulin test and polyamine methods were used. Various methods were used to identify antibodies, including saline, indirect antiglobulin test, polyamine and acid diffusion. This paper explores current methods for removing interference caused by monoclonal anti-cluster of differentiation 47. Hu5F9-G4 interferes with reverse typing of ABO blood groups, resulting in agglutination of all reagents used in antibody screening and identification. Patients' erythrocyte acid dispersive fluid reacted positively with spectrum cells and erythrocytes treated with papain reacted positively with serum. In saline and coagulant amine media, AK117 did not agglutinate with screening cells, but it did with antihuman globulin media. Pre-transfusion testing can be interfered with by anti-cluster of differentiation 47 antibodies. To ensure safe blood transfusions, patients should have their blood type tested and antibodies screened before treatment.

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“…Approved application of daratumab for monotherapy is on account of the safety and efficacy demonstrated in two clinical studies-GEN501 and Sirius. During the study of above projects, routine blood screening in blood banks showed consistently positive Indirect Anti-human globulin Test (IAT) results among patients who received daratumab therapy [9,10] . IAT, also called indirect Coombs test, typically used to test Red Blood Cell (RBC) alloantibody compatibility in plasma prior to transfusion [11,12] .…”

mentioning

confidence: 99%

Interference Analysis of Monoclonal Antibody Cluster of Differentiation 38 on ABO Blood Group Identification and Cross-Matching

Wang¹,

Qiu²,

Shao³

et al. 2022

IJPS

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We attempt to analyze and adopt the interference of monoclonal antibody cluster of differentiation 38 on ABO blood group identification and cross-matching. Search PubMed, Medline, Web of Science, China National Knowledge Infrastructure, Wanfang and other domestic and foreign databases, screening of patients requiring blood transfusion after receiving anti-cluster of differentiation 38 monoclonal antibody, retrospective analysis of anti-human globulin cassette method for antibody screening and cross-matching of serum from patients treated with cluster of differentiation 38 monoclonal antibody. According to the search results, a total of 185 patients who received cluster of differentiation 38 as monotherapy or combination therapy and required blood transfusion were retrieved. Among them, 98 cases of multiple myeloma, 22 cases of chronic lymphocytic leukemia and 16 cases of relapsed acute myeloid leukemia, total was 136 cases. But among the 124 patients who received daratumab treatment, a total of 49 patients (39.5 %) received 236 blood transfusions during treatment. Among these, 47 patients (37.9 %) received 147 red blood cell infusions, 17 patients (13.7 %) received 89 platelet transfusions. Among the systemic lupus erythematosus patients, there was only one case of transfusion-related reactions after platelet (rather than red blood cell) transfusion and no other adverse reactions. In the investigation of multiple bone marrow-related diseases, we found that 5 cases developed indirect antiglobulin test and were weakly positive, all patients did not see any discrepancies in ABO blood type identification. Antibody identified panagglutination occurred in only 1 patient with multiple myeloma. Among the multiple myeloma patients, cluster of differentiation 38 possessed a low expression on the surface of erythrocytes and its level on erythrocytes does not differ between individuals. After anti-cluster of differentiation 38 injections, macrophages increased, i.e. the antigen of cluster of differentiation 38 molecules in the patient's own erythrocyte falls off. Cluster of differentiation 38 monoclonal antibody substantially made no interference with ABO, rhesus or extended antigen matching. In antibody screening and cross-matching, cluster of differentiation 38 monoclonal antibody caused interference only at indirect antiglobulin test, showing antibody agglutination intensity 1 + or weaker reactivity. Hematological diseases such as multiple myeloid in antibody screening and cross-matching, anticluster of differentiation 38 antibody only caused interference in indirect antiglobulin test, showing weaker reactivity; cluster of differentiation 38 monoclonal antibody substantially made no interference with ABO, rhesus or extended antigen matching.

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Impact of new myeloma agents on the transfusion laboratory

Cited by 8 publications

References 68 publications

Anti‐CD38 monoclonal antibody interference with blood compatibility testing: Differentiating isatuximab and daratumumab via functional epitope mapping

Anti‐CD38 monoclonal antibody interference with blood compatibility testing: Differentiating isatuximab and daratumumab via functional epitope mapping

The Interference of Monoclonal Anti-Cluster of Differentiation 47 on Transfusion Compatibility Testing

Interference Analysis of Monoclonal Antibody Cluster of Differentiation 38 on ABO Blood Group Identification and Cross-Matching

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