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Interference Analysis of Monoclonal Antibody Cluster of Differentiation 38 on ABO Blood Group Identification and Cross-Matching

Author(s): Xuechun Wang, Hongmei Qiu*, Yan Shao and Yicen Chen
Laboratory Department, Jiaxing First Hospital, Jiaxing, Zhejiang 314000, 1The Second People’s Hospital of Pinghu, Pinghu 314419, 2The Second People’s Hospital of Haining, Haining, Zhejiang Province 314201, P. R. China

Correspondence Address:
Hongmei Qiu, Laboratory Department, Jiaxing First Hospital, Jiaxing, Zhejiang 314000, P. R. China, E-mail:

We attempt to analyze and adopt the interference of monoclonal antibody cluster of differentiation 38 on ABO blood group identification and cross-matching. Search PubMed, Medline, Web of Science, China National Knowledge Infrastructure, Wanfang and other domestic and foreign databases, screening of patients requiring blood transfusion after receiving anti-cluster of differentiation 38 monoclonal antibody, retrospective analysis of anti-human globulin cassette method for antibody screening and cross-matching of serum from patients treated with cluster of differentiation 38 monoclonal antibody. According to the search results, a total of 185 patients who received cluster of differentiation 38 as monotherapy or combination therapy and required blood transfusion were retrieved. Among them, 98 cases of multiple myeloma, 22 cases of chronic lymphocytic leukemia and 16 cases of relapsed acute myeloid leukemia, total was 136 cases. But among the 124 patients who received daratumab treatment, a total of 49 patients (39.5 %) received 236 blood transfusions during treatment. Among these, 47 patients (37.9 %) received 147 red blood cell infusions, 17 patients (13.7 %) received 89 platelet transfusions. Among the systemic lupus erythematosus patients, there was only one case of transfusion-related reactions after platelet (rather than red blood cell) transfusion and no other adverse reactions. In the investigation of multiple bone marrow-related diseases, we found that 5 cases developed indirect antiglobulin test and were weakly positive, all patients did not see any discrepancies in ABO blood type identification. Antibody identified panagglutination occurred in only 1 patient with multiple myeloma. Among the multiple myeloma patients, cluster of differentiation 38 possessed a low expression on the surface of erythrocytes and its level on erythrocytes does not differ between individuals. After anti-cluster of differentiation 38 injections, macrophages increased, i.e. the antigen of cluster of differentiation 38 molecules in the patient’s own erythrocyte falls off. Cluster of differentiation 38 monoclonal antibody substantially made no interference with ABO, rhesus or extended antigen matching. In antibody screening and cross-matching, cluster of differentiation 38 monoclonal antibody caused interference only at indirect antiglobulin test, showing antibody agglutination intensity 1+ or weaker reactivity. Hematological diseases such as multiple myeloid in antibody screening and cross-matching, anticluster of differentiation 38 antibody only caused interference in indirect antiglobulin test, showing weaker reactivity; cluster of differentiation 38 monoclonal antibody substantially made no interference with ABO, rhesus or extended antigen matching.

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