背景:建议用二硫苏糖醇(DTT)预处理试剂红细胞以使表面CD38变性,以防止抗CD38单克隆抗体(MoAb)干扰血液相容性测试。抗CD38对Polybrene测试影响不大,但与标准的基于DTT的方法相比,检测不规则抗体的敏感性和有效性尚不清楚。
方法:收集21名接受达雷妥单抗(N=13)和伊沙妥昔单抗(N=8)的患者血清。标准抗血清(抗c,D,E,FYB,Jka,M,将连续稀释的Mia)添加到患者血清中。抗体筛选测试同时使用手动polybrene方法(MP)和DTT预处理,自动间接抗球蛋白试验(DTT-IAT)比较检测灵敏度。还对这两种方法的运行时间和成本进行了分析。
结果:MP和DTT-IAT都可以克服抗CD38MoAb引起的干扰。然而,MP在检测抗M和抗Mia方面更灵敏,并且在检测其他抗体方面与DTT-IAT相当。在成本和运营时间方面,MP也远远优于DTT-IAT。
结论:MP在解决抗CD38干扰方面是DTT-IAT的一种具有成本效益的替代方法,尤其适用于抗M和抗Mia流行率较高的人群。然而,这两种方法都有一个众所周知的缺点,即抗K检测灵敏度低,应向患者提供K单位,以防止溶血性输血反应。
BACKGROUND: It is advised to pretreat the reagent erythrocytes with Dithiothreitol (DTT) to denature the surface CD38 to prevent anti-CD38 monoclonal antibodies (MoAb) from interfering with the blood compatibility test. Anti-CD38 has little impact on the Polybrene test, but it is still unknown how sensitive it is to detect irregular antibodies and how effective it is when compared to the standard DTT-based method.
METHODS: Twenty-one patients receiving daratumumab (N = 13) and isatuximab (N = 8) had their serum collected. Standard anti-sera (anti-c, D, E, Fyb , Jka , M, Mia ) with serial dilution were added to patients\' serum. Antibody screening tests were performed simultaneously using the manual polybrene method (MP) and DTT-pretreated, automatic indirect antiglobulin test (DTT-IAT) to compare the detection sensitivity. These two methods\' operating times and costs were also analyzed.
RESULTS: Both MP and DTT-IAT can overcome the interference caused by anti-CD38 MoAb. However, MP is more sensitive in detecting anti-M and anti-Mia and is comparable to DTT-IAT in detecting other antibodies. In terms of cost and operating time, MP is also far superior to DTT-IAT.
CONCLUSIONS: MP is a cost-effective alternative to DTT-IAT in resolving anti-CD38 interference and is especially suitable for populations with a high prevalence of anti-M and anti-Mia . However, both methods have a well-known drawback of low detection sensitivity for anti-K, and K-units should be provided to patients to prevent hemolytic transfusion reactions.