International validation of a dithiothreitol (DTT)-based method to resolve the daratumumab interference with blood compatibility testing

Claudia I. Chapuy, Maria D. Aguad, Rachel T. Nicholson, James P. Aubuchon, Claudia S. Cohn, Meghan Delaney, Mark K. Fung, Meredith Unger, Parul Doshi, Michael F. Murphy, Larry J. Dumont, Richard M. Kaufman

Research output: Contribution to journalArticlepeer-review

59 Scopus citations

Abstract

BACKGROUND: Daratumumab (DARA) consistently interferes with routine blood bank serologic testing by directly binding to CD38 expressed on reagent red blood cells (RBCs). Treating RBCs with dithiothreitol (DTT) eliminates the DARA interference. We conducted an international, multicenter, blinded study aimed at validating the DTT method for use by blood bank laboratories worldwide. STUDY DESIGN AND METHODS: Paired plasma sample unknowns were sent to 25 participating blood bank laboratories. Sample 1 was spiked with DARA only (10 µg/mL), and Sample 2 with DARA plus a clinically significant RBC antibody (anti-D [n = 6], anti-Fya [n = 9], or anti-s [n = 10]). Sites were instructed to perform an antibody screen with and without DTT-treated RBCs and to use a DTT-treated RBC panel for antibody identification. Qualitative data about the DTT method were collected by online survey. The primary outcome was the proportion of study sites able to identify the antibody unknown in the presence of DARA. RESULTS: All sites observed the DARA interference with the antibody screen. The DARA interference was seen with all testing methods (gel, tube, or solid phase). Using the DTT method, 25 of 25 sites (100%) successfully identified the antibody unknown in the presence of DARA. Feedback on the DTT method was positive, with 17 of 19 (90%) sites responding to the survey indicating that they planned to use the DTT method to test clinical samples from DARA-treated patients. CONCLUSION: The DTT method is robust and reproducible and can be implemented by transfusion services worldwide to help provide safe blood products to patients treated with DARA.

Original languageEnglish (US)
Pages (from-to)2964-2972
Number of pages9
JournalTransfusion
Volume56
Issue number12
DOIs
StatePublished - Dec 1 2016

Bibliographical note

Publisher Copyright:
© 2016 AABB

Fingerprint

Dive into the research topics of 'International validation of a dithiothreitol (DTT)-based method to resolve the daratumumab interference with blood compatibility testing'. Together they form a unique fingerprint.

Cite this