Detection of Anti-CD38 immunotherapy interference with pre-transfusion antibody screening using LISS & Polybrene

Immunotherapy drugs such as Anti-CD38 (Daratumumab) interfere with pre-transfusion antibody screening tests. The purpose of this present study is to evaluate and compare the results of Qatar-based patients taking anti-CD38 using the Polybrene technique (LIP/LIPAT) and low-ionic- strength saline-indirect antiglobulin test (LISS-IAT) when conducting antibody pre-transfusion screening. Twenty (20) residual plasma samples from patients taking anti-CD38 medication were tested using the LIP/LIPAT and LISS-IAT against Immucor Panoscreen three cells. The results were then compared and graded from 0 to 4+ based on their strength of agglutination. The samples tested using LISS-IAT were positive, with reactions ranging from weak positive to 1+ only in the AHG phase. On the other hand, all samples tested negative using the manual LIP. However, in the LIPAT test, 95% of the samples tested positive microscopically. In conclusion, patients taking immunotherapy drugs such as Anti-CD38 can use the manual Polybrene or LIP as the method of choice in conducting pre-transfusion screening as these yields more accurate results.

Keywords – Antibody screening, Anti-CD38 drugs, Immunotherapy, Monoclonal antibody, Polybrene