F(ab ')(2) Fragments to Overcome Daratumumab Interference in Transfusion Tests

Abstract

Daratumumab is an antibody directed against CD38 for the treatment of multiple myeloma.¹ CD38 is also expressed on red-cell membranes, so that free daratumumab in patient serum can bind to test erythrocytes during pretransfusion blood-compatibility testing. This results in panreactive agglutination in the standard indirect antihuman globulin (Coombs’) test used for antibody screening and cross-matching.² Consequently, clinically relevant red-cell alloantibodies may not be recognized in patients who have received daratumumab.