Immunhämatologische Daratumumab-Interferenz im Verlauf einer Myelomtherapie

Grüger, Daniela; Immenschuh, Stephan; Hervatin, Rafaela; Schneeweiß, Clemens

doi:10.1055/a-1521-8045

Cited by 1 publication

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“…False positive IATs due to anti‐CD38‐mediated pan‐agglutination can occur up to 6 months after the last Daratumumab administration 8 . However, MM‐patients treated with anti‐CD38 antibodies often require transfusion of RBCs during the course of the therapy, sometimes repeatedly (as described in Grueger et al 9 ). The anti‐CD38 antibody interference may delay the required pre‐transfusion diagnostic or, in the worst case, even prevent a timely transfusion of donor blood.…”

Section: Introductionmentioning

confidence: 99%

Mitigation of therapeutic anti‐CD38 antibody interference with fab fragments: How well does it perform?

Habicht¹,

Ridders²,

Grueger

et al. 2023

Transfusion

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Background: Administration of anti-CD38 antibodies is a state-of-the-art therapy for patients diagnosed with multiple myeloma (MM). However, this treatment frequently leads to pan-agglutination of red blood cells (RBCs) in patients' serological testing making accurate blood typing and timely transfusion of compatible blood a challenging effort. The antigen masking indirect antiglobulin test (AMIAT) is an approach to address this diagnostic challenge.Study Design and Methods: A new reagent, called DaraEx plus, uses anti-CD38 Fab fragments to mitigate the anti-CD38 antibody interference in serological assays by masking CD38 on the cell surface. Its performance is extensively examined with commercial sera as well as with patient samples, and compared to the current standard method using dithiothreitol (DTT), which denatures the CD38 antigens on test panel erythrocytes.Results: In the Bio-Rad ID System, DaraEx plus effectively mitigated the interference caused by anti-CD38 antibodies in 86% of patient samples tested while DTT was successful in only 68%. Moreover, there was no negative influence on DTT-sensitive blood group systems such as KEL upon DaraEx plus treatment. The agglutination reactions of all tested anti-CD38 antibodies (Daratumumab, Felzartamab, and Isatuximab) were inhibited by DaraEx plus. The treatment was successful only if DaraEx plus was added to the test cells before the sample. Some of the other gel card systems tested showed background reactions with DaraEx plus-treated cells. Conclusion: DaraEx plus treatment is straightforward and quick to perform.In the Bio-Rad ID System, it is superior to DTT treatment in the prevention of anti-CD38 antibody interference.

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Section: Introductionmentioning

confidence: 99%