We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Use of an in‐house trypsin‐based method to resolve the interference of daratumumab.
- Authors
Ibeh, Nnaemeka; Baine, Ian; Rudon, Louella Fuentes; Lomas‐Francis, Christine; Jhang, Jeffrey S.; Galdon, Patricia; Westhoff, Connie M.; Velliquette, Randall W.; Arinsburg, Suzanne A.
- Abstract
Background: Daratumumab (DARA) is a monoclonal antibody for treatment of plasma cell myeloma targeting CD38, a surface molecule expressed on plasma cells and red blood cells (RBCs). This complicates blood bank testing, requiring dithiothreitol (DTT) to remove DARA interference. A simple in‐house method of removing DARA interference without use of DTT, a potentially hazardous chemical, is desirable. We demonstrate a trypsin‐based method to remove interference in antibody testing at a medical center (MC), with parallel testing at an immunohematology reference laboratory (IRL). Study design and methods: Pre‐DARA type and screen (T&S) samples were obtained from 61 patients for antibody testing and RBC phenotyping using untreated reagent RBCs. Subsequent post‐DARA T&S testing was performed with untreated reagent RBCs to demonstrate interference and repeated after trypsin treatment. Positive trypsin‐treated antibody screens were reflexed to antibody identification using trypsin‐treated panel cells. Parallel testing was performed on the same post‐DARA samples at IRL. Results: DARA interference was detected in 61/61 (100%) samples by MC and IRL. After trypsin treatment, DARA interference was eliminated in 60/61 (98.4%) antibody screens by both institutions with an overall percent agreement of 96.7% (95% confidence interval [CI] 88.7%–99.6%). Identification of known alloantibodies was confirmed in 3/3 patients with 100% concordant results between MC and IRL. There were no false‐negative results demonstrated by IRL's functionally CD38‐negative controls. Conclusion: Our in‐house trypsin‐based method enables pretransfusion testing of patients receiving DARA in an accurate and cost‐effective manner without missing clinically significant alloantibodies. This presents an additional testing option where DTT use is undesirable.
- Subjects
IRELAND; DARATUMUMAB; MULTIPLE myeloma; ANTIBODY titer; PLASMA cells; ERYTHROCYTES
- Publication
Transfusion, 2021, Vol 61, Issue 10, p3000
- ISSN
0041-1132
- Publication type
Article
- DOI
10.1111/trf.16635