A Brief Report on Pre-Transfusion Testing in Patients Receiving the Anti-CD38 Monoclonal Antibody for Hematological Disorders in India

Abstract

The aim of this study is to analyze the profile of patients receiving daratumumab and their presentation to the transfusion laboratory by looking at the different pre-transfusion policies and the risk of erythrocyte alloimmunization. Patients receiving daratumumab from 2018 to 2023 were reviewed. They were divided into two groups: Group I, presented before administration of daratumumab, and Group II, presented after drug administration. Appropriate strategies were applied to mitigate the drug interference, and the transfusion outcome was analyzed by following up with the patients for six months. A total of 48 patients were studied. The antibody screen was negative in patients who presented before the administration of daratumumab (n = 35). Extended phenotyping was done for 31 patients. Blood group genotyping was done for 4 patients. The patients who presented after daratumumab administration (n = 13) had a positive antibody screen that became negative with dithiothreitol-treated cells. A total of 261 red cell units were transfused to these patients (mean 5.55 units per patient). None of the patients developed antibodies during the follow-up period. The transfusion services must frame policies and protocols to mitigate drug interference. Good communication between transfusion services and clinical hematologists is a must to ensure safe transfusions.