凝聚胺法去除经CD38单抗治疗多发性骨髓瘤血型血清学干扰的探讨

Removal of serological interference in the treatment of multiple myeloma with CD38 monoclonal antibody using polybrene method

目的探讨凝聚胺法去除CD38单抗治疗多发性骨髓瘤血型血清学干扰及同种抗体检测的临床可行性。方法采用凝聚胺法和增强凝聚胺法对CD38单抗治疗的多发性骨髓瘤患者进行不规则抗体筛查和交叉配血试验。结果凝聚胺法可去除CD38单抗类药物对血型血清学的干扰;2种凝聚胺法均可有效去除CD38单抗干扰检出抗-E、抗-D、抗-Fy^(a)和抗-S抗体,且增强凝聚胺法测定抗-D、抗-E、抗-Fy^(a)和抗-S同种抗体效价均高于凝聚胺法;7例患者给予K抗原阴性血液输注均未发生输血不良反应。结论凝聚胺法可快速、有效去除经CD38单抗治疗多发性骨髓瘤血型血清学干扰。

Objective To investigate the clinical feasibility of polybrene method to remove serological interference in patients receiving anti-CD38 monoclonal antibody for the treatment of multiple myeloma,and its detection performance of alloantibodies.Methods For patients receiving anti-CD38 monoclonal antibody for the treatment of multiple myeloma,unexpected antibody screening and cross-matching blood test were performed by polybrene method.Results The polybrene method can remove the interference of anti-CD38 monoclonal antibodies on blood group serology;both methods can effectively remove anti-CD38 monoclonal antibody to detect anti-E,anti-D,anti-Fy^(a) and anti-S antibodies.The titers of anti-D,anti-E,anti-Fy^(a) and anti-S alloantibodies,yielded by enhanced polybrene method,were higher than those of the polybrene method.Seven patients received K-antigen-negative blood transfusion without any adverse reactions to blood transfusion.Conclusion For the treatment of multiple myeloma using CD38 monoclonal antibody,the polybrene method can quickly and effectively remove the interference of daratumumab with blood group serology.