A method for eliminating interference in antibody differentiation and pre-transfusion cross-match by therapeutic antibodies and for improving antibody differentiation in the presence of multiple auto, allo or therapeutic antibodies in tansfusion medicine

摘要

Therapeutic antibodies (AK) infused into a patient can interfere with the so-called antibody screening test (AKSU) and the serological compatibility test (SVP), thus jeopardizing the safe supply of patients with anemia with blood products (erythrocytes). So far, no problem solution is described on how to block blood group antigens and turn off the interference. Solution to Problem The interfering antigens on AKSU search cells or donor cells (erythrocytes) are masked with substances. These substances are added before or at the same time as the patient sample. After that, the AKSU and the SVP can be performed without interference. An example of such an AK is daratumumab, an AK against CD38 on red blood cells. Cleavage of the antibody in vitro with a protease (e.g., papain) results in AK fragments, e.g. Fab. These AK fragments are used to mask the CD38 in vitro. The DARA-AK in the patient's blood can then no longer interfere in the test system. Area of application In the field of transfusion medicine, it is to be expected that the increased use of therapeutic antibodies, e.g. Daratumumab is increasingly causing a diagnostic problem for patient care with compatible blood. The described method may in future be applied to other iatrogenic AK or immune auto or alloantibodies.