Thirty‐three‐day storage of dithiothreitol‐treated red blood cells used to eliminate daratumumab interference in serological testing

Lorenzen, Henriette; Akhtar, Nazia; Nielsen, Maria; Svendsen, Lea; Andersen, Pernille

doi:10.1111/vox.12699

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…The concentration of 0.2 M DTT is known to cause hemolysis of RBCs with storage. [8][9][10][11][12] The present center has experienced the same. Treating screening RBCs every time a requisition is received delays transfusion.…”

Section: Discussionmentioning

confidence: 99%

“…Hemolysis in 0.2 M DTT-treated RBCs was observed from 4 to 28 days of preparation in various studies. [8][9][10][11][12] Use of stabilizing agents like Alsever's solution and PBS at pH 7.3 have also been tried to preserve DTT-treated RBCs. [8][9][10][11] In the present study, the DTT-treated RBCs were suspended in PBS.…”

Section: Discussionmentioning

confidence: 99%

“…DTT treatment of RBCs has the potential to cause hemolysis at certain concentrations which can interfere with interpretation of results. [8][9][10][11][12] Standard DTT treatment of RBCs is performed with 0.2 M DTT, although at this concentration hemolysis was observed and has been documented. A lower concentration (i.e., 0.1 M DTT) can be used for the same purpose.…”

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confidence: 99%

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Blood component administration to multiple myeloma patients treated with daratumumab: suggesting a novel approach with use of 0.1 M dithiothreitol

et al. 2020

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Storage of dithiothreitol (DTT)-treated red blood cells (RBCs) leads to hemolysis. The aim of this study was to compare 0.1 M DTT with 0.2 M DTT treatment of RBCs and to share our experience of providing components to seven patients on daratumumab (DARA). This prospective, observational study included patients who required RBC transfusion within 6 months of DARA administration. All patients underwent a baseline serologic evaluation followed by a repeat evaluation after DARA administration. In addition, use of 0.1 M DTT was compared with 0.2 M DTT in terms of concordance of results, hemolysis with storage of treated RBCs, and ease of use. A total of 22 RBC requisitions were received for seven patients. Antibody screen was positive for one patient (anti-C) at baseline; it was panreactive for all patients after DARA. Concordance of results between the two concentrations was 98.5 percent. Laboratory personnel found results obtained with use of 0.1 M DTT-treated RBCs easy to interpret. Supernatant hemoglobin was found to be significantly greater for 0.2 M DTT-treated RBCs at the sixth day of storage. In conclusion, component administration to patients on DARA can be done without delay if adequate policies and procedures are in place. Use of 0.1 M DTT-pretreated RBCs can be used to avoid delay in transfusion and reduce the burden on the laboratory of weekly preparation of 0.2 M DTT-treated RBCs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Blood component administration to multiple myeloma patients treated with daratumumab: suggesting a novel approach with use of 0.1 M dithiothreitol

et al. 2020

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Impact of Novel Monoclonal Antibody Therapeutics on Blood Bank Pretransfusion Testing

Mei

Wool

2019

Hematology/Oncology Clinics of North America

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A newly devised flow cytometric antibody binding assay helps evaluation of dithiothreitol treatment for the inactivation of CD38 on red blood cells

et al. 2020

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Background and objectives Anti-CD38 monoclonal antibodies, including daratumumab and isatuximab, often interfere with pretransfusion testing. Dithiothreitol (DTT) treatment of red blood cells (RBCs) negates this interference. However, the optimum DTT concentration and treatment time have not been well defined. Here, we quantified CD38 on RBCs before and after DTT treatment using a flow cytometric antibody binding assay (FABA) to specify the optimum conditions for CD38 inactivation.Materials and methods For FABA, untreated or DTT-treated RBCs were incubated with fluorescein isothiocyanate-labelled anti-CD38 antibody, in the presence or absence of 100-fold or more excess of unlabelled anti-CD38 antibody, and then analysed by flow cytometry (FCM). Dissociation of CD38-positive and control histograms was determined from the D-value using the Kolmogorov-Smirnov test. The results from FABA were compared with those from conventional FCM, indirect antiglobulin test (IAT) and Western blotting. ResultsThe results from FABA were more consistent than those from conventional FCM. The D-value was found to be reliable in the analysis of difference between CD38 before and after DTT treatment. Our data showed that 0Á0075 mol/ l DTT for 30 min is sufficient to inactivate CD38 on RBCs. These results were stable and consistent with the findings from IAT.Conclusion Flow cytometric antibody binding assay is an objective way of evaluating the efficacy of DTT treatment for CD38 on RBCs. This approach allows the detection of a small number of cell surface antigens and will be useful for assessing the various chemical treatments to denature RBC antigens.

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Thirty‐three‐day storage of dithiothreitol‐treated red blood cells used to eliminate daratumumab interference in serological testing

Abstract: The modified dithiothreitol method was able to reduce haemolysis during storage and to detect and identify alloantibodies in the presence of daratumumab.

Cited by 4 publications

References 14 publications

Blood component administration to multiple myeloma patients treated with daratumumab: suggesting a novel approach with use of 0.1 M dithiothreitol

Blood component administration to multiple myeloma patients treated with daratumumab: suggesting a novel approach with use of 0.1 M dithiothreitol

Impact of Novel Monoclonal Antibody Therapeutics on Blood Bank Pretransfusion Testing

A newly devised flow cytometric antibody binding assay helps evaluation of dithiothreitol treatment for the inactivation of CD38 on red blood cells

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