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International Journal of Blood Transfusion and Immunohematology - IJBTI - Review Articles, Original Articles, Short Communication, Case Series, Case Reports, Letter to Editors
 
     
Review Article
 
Management of daratumumab interference in Portuguese blood transfusion medicine: A literature review about unmet needs and challenges
Dialina Brilhante1, Teresa Chabert2, Anabela Brites3, Fátima Nascimento4, Maria José Rodrigues2, José António Duran5, Sérgio Barroso6, Rita Jaime7, Ana Maria Esesumaga8
1The Francisco Gentil Portuguese Institute of Oncology, Lisbon Center, Portugal
2The Portuguese Institute for Blood and Transplantation, Lisbon Center, Portugal
3Santa Maria University Hospital - North Lisbon Hospital Center, Lisbon, Portugal
4Hemovida, Transfusion Medicine Service Management, Lisbon, Portugal
5The Portuguese Institute for Blood and Transplantation, Oporto Center, Portugal
6Lenitudes – Medical Center & Research, Santa Maria da Feira, Portugal
7Janssen Pharmaceuticals Portugal, Lda., Queluz, Portugal
8The Coimbra Hospital and Universitary Center, Coimbra, Portugal

Article ID: 100037Z02DB2018
doi: 10.5348/100037Z02DB2018RA

Corresponding Author:
Dialina Brilhante,
The Francisco Gentil Portuguese Institute of Oncology,
Lisbon Center, Portugal,
Professor Lima Basto Street, 1099-023 Lisbon, Portugal

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How to cite this article
Brilhante D, Chabert T, Brites A, Nascimento F, Rodrigues MJ, Duran JA, Barroso S, Jaime R, Esesumaga AM. Management of daratumumab interference in Portuguese blood transfusion medicine: A literature review about unmet needs and challenges. Int J Blood Transfus Immunohematol 2018;8:100037Z02DB2018.


ABSTRACT

Multiple Myeloma is a malignant disease of the bone marrow plasma cells that mainly affects older people, and whose prognosis is reserved on relapsing or refractory disease. The arrival of CD38 monoclonal antibody daratumumab into the market allowed an increase in overall survival rate, with limited associated toxicity, for pre-treated multiple myeloma patients. However, this antibody interferes with pre-transfusion tests since erythrocytes also express, even at reduced levels, CD38 receptors. A literature review and discussion about this topic was performed by a board of Portuguese Immuno-hemotherapy experts. Based on the literature review, the mechanisms by which daratumumab interferes with pre-transfusion tests and may mask the presence of irregular antibodies in plasma of treated patients, which may result in difficulties in preparing and delivering results and blood components to be transfused, were identified and discussed. In addition, the applicable strategies in clinical practice to mitigate this interference were identified, namely the denaturing method of CD38 with dithiothreitol, considered an inexpensive, reproducible, reliable and validated technique, although with logistic limitations and should not be ignored. The experts also assessed and discussed the main concerns and priorities of transfusion medicine services, considering the limitations of this technique and its implication in routines for tranfusional support. The experts agreed on the importance of communication between physicians, hematologists, immuno-hemotherapy specialists, nurses and patients, as well as the need to align all methodologies to develop global and universal protocols to the various clinical analysis laboratory centers.

Keywords: Blood tests, Daratumumab, Dithiothreitol, Transfusion Medicine


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Author Contributions
Dialina Brilhante – Substancial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Teresa Chabert – Substancial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Anabela Brites – Substancial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Fátima Nascimento – Substancial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Maria José Rodrigues – Substancial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
José António Duran – Substancial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Sérgio Barroso – Substancial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Rita Jaime – Substancial contributions to conception and design, analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ana Maria Esesumaga – Substancial contributions to conception and design, analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of Submission
The corresponding author is the guarantor of submission.
Source of Support
None
Conflict of Interest
The authors whose names are listed immediately below declare that they performed the functions of experts in medical events developed by Janssen Pharmaceuticals Portugal, and received honoraria for the provision of these services. Author names: Dialina Brilhante, Teresa Chabert, Maria José Rodrigues, José António Duran, Ana Maria Esesumaga.
The author whose name is listed immediately below declares that she performed the functions of expert and speaker in medical events developed by Janssen Pharmaceuticals Portugal, and received honoraria for the provision of these services. Author name: Fátima Nascimento.
The author whose name is listed immediately below declares that is employed at Janssen Pharmaceuticals Portugal. Author name: Rita Jaime.
Copyright
© 2018 Dialina Brilhante et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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