A Case of Panagglutination on Antibody Identification in a Multiple Myeloma Patient Receiving Daratumumab.
10.17945/kjbt.2016.27.2.164
- Author:
Jooyoung CHO
1
;
Hyunjin NAH
;
Daewon KIM
;
Eunkyung LEE
;
Jin Seok KIM
;
Hyun Ok KIM
Author Information
1. Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. hyunok1019@yuhs.ac
- Publication Type:Case Report
- Keywords:
Daratumumab;
CD38;
Panagglutination;
Dithiothreitol (DTT)
- MeSH:
Aged;
Antigens, CD38;
Drug Therapy;
Erythrocytes;
Female;
Humans;
Korea;
Mass Screening;
Multiple Myeloma*;
Peripheral Blood Stem Cell Transplantation
- From:Korean Journal of Blood Transfusion
2016;27(2):164-168
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Herein, we report a patient showing panagglutination in the unexpected antibody identification test after the administration of daratumumab. The patient was a 66-year-old woman who had undergone multiple cycles of chemotherapy and autologous peripheral blood stem cell transplantation for treating multiple myeloma; however, despite treatment, she had relapsed. Therefore, daratumumab, on clinical trials in Korea, started to be administered. After administration of daratumumab, the result of antibody screening test was positive, on the contrary to the result prior to the administration. Moreover, all positive reactions were shown in the antibody identification to the panel cells. After destroying CD38 antigens on the surface of RBCs using DTT, negative results were obtained. Daratumumab—a novel therapeutic human CD38 monoclonal antibody that can be used as targeted immunotherapy—is an FDA-approved drug for treating multiple myeloma. Because CD38 is expressed not only on myeloma cells, but also on red blood cells (RBCs), the use of daratumumab might lead to RBC agglutinations, and thereby resulting in false-positive results on the pre-transfusion tests. Therefore, caution is needed in case of a patient receiving daratumumab. Furthermore, additional test using DTT is required, especially when panagglutination was shown in the antibody identification test, as in this case.
