Overcoming Drug Interference in Transfusion Testing: A Spotlight on Daratumumab.

TitleOvercoming Drug Interference in Transfusion Testing: A Spotlight on Daratumumab.
Publication TypeJournal Article
Year of Publication2021
AuthorsNedumcheril MT, DeSimone RA, Racine-Brzostek SE, Chaekal OKyong, Vasovic LV
JournalJ Blood Med
Date Published2021

Daratumumab, a monoclonal antibody therapeutic, is highly efficacious and widely used in all stages of multiple myeloma and amyloidosis and has promising activity in other hematologic disorders. Daratumumab interacts with red blood cells, interfering with pre-transfusion testing. This interference can lead to compromising transfusion safety, extensive blood bank work ups and delays in provision of compatible units. Several methods have been developed to negate daratumumab interference with indirect antiglobulin testing. They are based on i) standard blood bank techniques including dithiothreitol and enzymatic treatment of reagent cells, using reagent red blood cells negative for CD38, ii) blocking CD38 antigens on reagent or donor cells, iii) neutralization of anti-CD38 antibody in patient plasma prior to testing, and iv) extended antigen typing of patient red blood cells in conjunction with provision of phenotypically matched units for transfusion. Implementation of those methods by the blood bank should be a planned effort coordinated with the patient's clinical team. Timely involvement of blood bank and transfusion services and educational efforts by both blood banks and clinical providers can improve the overall daratumumab safety profile in regard to blood transfusion.

Alternate JournalJ Blood Med
PubMed ID34079412
PubMed Central IDPMC8164699
Related Faculty: 
Robert DeSimone, M.D. Sabrina Racine-Brzostek, M.D., Ph.D.

Pathology & Laboratory Medicine 1300 York Avenue New York, NY 10065 Phone: (212) 746-6464
Surgical Pathology: (212) 746-2700