低浓度二硫苏糖醇去除CD38单抗干扰输血相容性检测的评估

Evaluation of Low Concentration Dithiothreitol for Negating the Monoclonal Anti-CD38 Interference with Transfusion Compatibility Testing

目的:探讨低浓度二硫苏糖醇(DTT)去除CD38单抗对输血相容性检测干扰的有效性和安全性,制定合理的临床输血策略。方法:按照标准方法进行血型表型、直接抗人球蛋白试验及抗体筛查,分别用0.2、0.1、0.05、0.02、0.01和0.005 mol/L的DTT处理抗筛细胞及供者红细胞,用抗人球蛋白卡式法对CD38单抗治疗后血清进行抗体筛查及交叉配血。结果:DTT 0.01 mol/L 37℃处理检测红细胞30 min可以去除CD38单抗对抗体筛查及交叉配血的影响,同时保留其对抗-K、抗-LW、抗-JMH、抗-Lub、抗-e、抗-Dia及抗-Jka同种抗体检测的有效性。10例患者红细胞输注后均未发生急性或迟发性溶血性输血反应,血常规检测显示红细胞输注有效。结论:0.01 mol/L DTT在去除CD38单抗对输血相容性检测干扰的同时保留了对大多数同种抗体的检测能力,该方法安全有效。

Objective:To investigate the effectiveness and safety of low concentration dithiothreitol(DTT)in removing the interference of monoclonal anti-CD38 on transfusion compatibility testing,and develop a reasonable clinical transfusion strategy.Methods:The blood type,direct antiglobulin testing(DAT)and antibody screening were tested according to standard methods.Antibody screening cells and donor′s red blood cells were treated by DTT 0.2,0.1,0.05,0.02,0.01 and 0.005 mol/L,and antibody screening and cross-matching of serums after monoclonal anti-CD38 treatment were performed by anti-human globulin card.Results:The 0.01 mol/L DTT at 37℃for 30 minutes could remove the effect of monoclonal anti-CD38 on antibody screening and cross-matching,meanwhile retain their effectiveness in detecting anti-K,anti-LW,anti-JMH,anti-Lub,anti-e,anti-Dia and anti-Jka alloantibodies.All the 10 patients had no acute or delayed haemolytic transfusion reactions and their routine blood tests showed that the red blood cells transfusion was effective.Conclusion:The 0.01 mol/L DTT is a safe and effective method for removing the interference of monoclonal anti-CD38 with transfusion compatibility testing,while retaining the ability to detect most alloantibodies.