Antibody testing in patients treated with anti-CD38: there is still room for improvement

Abstract

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With the introduction of the first anti-CD38 antibody, daratumumab, in the therapy of multiple myeloma, immunohaematology became more complicated1,2. Daratumumab is a humanised (IgG1 kappa) monoclonal antibody. CD38 is present on red blood cells (RBC). Similar to irregular antibodies, anti-CD38 binds to the RBC and is detected by the antiglobulin reagents used for the detection of irregular antibodies; hence, the antibody screen becomes positive. The interference of anti-CD38 may persist for months. The matter becomes even more complicated by the observation that usually the target epitope of anti-CD38 is barely present on the patient’s RBC, resulting in a pattern similar to an antibody to an antigen of high prevalence. [ … ]