Stability guidelines for dithiothreitol-treated red blood cell reagents used for antibody detection methods in patients treated with daratumumab

Publications

Share / Export Citation / Email / Print / Text size:

Immunohematology

American National Red Cross

Subject: Medical Laboratory Technology

GET ALERTS

ISSN: 0894-203X
eISSN: 1930-3955

DESCRIPTION

32
Reader(s)
79
Visit(s)
0
Comment(s)
0
Share(s)

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue / page

Related articles

VOLUME 33 , ISSUE 3 (September 2017) > List of articles

Stability guidelines for dithiothreitol-treated red blood cell reagents used for antibody detection methods in patients treated with daratumumab

Wendy L. Disbro

Keywords : immunohematology, daratumumab, dithiothreitol, stability, antigen

Citation Information : Immunohematology. Volume 33, Issue 3, Pages 105-109, DOI: https://doi.org/10.21307/immunohematology-2019-015

License : (Transfer of Copyright)

Published Online: 09-October-2019

ARTICLE

ABSTRACT

Daratumumab (DARA), a drug used to treat patients with multiple myeloma, causes interference in pre-transfusion testing. Samples from patients receiving DARA exhibit panreactivity in antibody detection and identification tests with red blood cells (RBCs). Many hospitals are sending these samples to reference laboratories. Dithiothreitol (DTT), a sulfhydryl chemical treatment of RBCs, negates this reactivity. This study investigated the stability of the antigens on DTT-treated RBCs to determine if large quantities of RBCs could be treated at one time, stored, and used for testing at a later time. Panel cells were treated with DTT and then stored as three sets. Set 1 DTT-treated RBCs were stored in Alsever’s solution at 2°C to 8°C, washed daily, and suspended in pH 7.3 phosphate-buffered saline (PBS) prior to antigen typing. Set 2 DTT-treated RBCs were stored in pH 7.3 PBS. Set 3 DTT-treated RBCs were stored in Alsever’s solution. Sets 2 and 3 were inspected daily for 14 days for observation of hemolysis. In Set 1, all antigen reactivity remained at ≥2+ with both single- and double-dose cells for 14 days. The Rh antigens gave stronger reactions longer, compared with those tested in the Duffy, Kidd, and MNS blood group systems. Sets 2 and 3 were monitored for hemolysis. On day 3, Set 2 began displaying hemolysis, with complete hemolysis by day 8. Set 3 did not display hemolysis in 14 days. In conclusion, a large volume of RBCs can be treated with DTT and stored in Alsever’s solution for use without deterioration of the RBC antigens, saving institutions tech time, resources, and money.

Content not available PDF Share

FIGURES & TABLES

REFERENCES

1. de Weers M, Tai YT, van der Veer MS, et al. Daratumumab, a novel therapeutic human CD38 monoclonal antibody, induces killing of multiple myeloma and other hematological tumors. J Immunol 2011;186:1840–8.

2. Chapuy CI, Nicholson RT, Aguad MD, et al. Resolving the daratumumab interference with blood compatibility testing. Transfusion 2015;55:1545–54.

3. Plesner T, Lokhorst H, Gimsing P, et al. Daratumumab, a CD38 monoclonal antibody in patients with multiple myeloma: data from a dose-escalation phase I/II study. ASH Annual Meeting Abstracts 2012;120:73.

4. Fung MK, Grossman BJ, Hillyer CD, Westhoff CM, Eds. Technical manual. 18th ed. Bethesda, MD: AABB, 2014.

5. Harmening D. Modern blood banking and transfusion practices. 5th ed. Baltimore, MD: FA Davis, 2005. 6. Reid ME, Lomas-Francis C, Olsson ML. The blood group antigen facts book. 3rd ed. Waltham, MA: Academic Press, 2012.

EXTRA FILES

COMMENTS