Use of standard laboratory methods to obviate routine dithiothreitol treatment of blood samples with daratumumab interference


Share / Export Citation / Email / Print / Text size:


American National Red Cross

Subject: Medical Laboratory Technology


ISSN: 0894-203X
eISSN: 1930-3955





Volume / Issue / page

Volume 37 (2021)
Volume 36 (2020)
Volume 35 (2019)
Volume 34 (2018)
Volume 33 (2017)
Volume 32 (2016)
Volume 31 (2015)
Volume 30 (2014)
Volume 29 (2013)
Volume 28 (2012)
Volume 27 (2011)
Volume 26 (2010)
Volume 25 (2009)
Volume 24 (2008)
Volume 23 (2007)
Volume 22 (2006)
Volume 21 (2005)
Volume 20 (2004)
Volume 19 (2003)
Volume 18 (2002)
Volume 17 (2001)
Volume 16 (2000)
Volume 15 (1999)
Volume 14 (1998)
Volume 13 (1997)
Volume 12 (1996)
Volume 11 (1995)
Volume 10 (1994)
Volume 9 (1993)
Volume 8 (1992)
Volume 7 (1991)
Volume 6 (1990)
Volume 5 (1989)
Volume 4 (1988)
Volume 3 (1987)
Related articles

VOLUME 33 , ISSUE 1 (March 2017) > List of articles

Use of standard laboratory methods to obviate routine dithiothreitol treatment of blood samples with daratumumab interference

Nicholas J. Lintel * / Debra K. Brown / Diane T. Schafer / Farai M. Tsimba-Chitsva / Scott A. Koepsell / Sara M. Shunkwiler

Keywords : daratumumab, pre-transfusion testing, interference

Citation Information : Immunohematology. Volume 33, Issue 1, Pages 22-26, DOI:

License : (Transfer of Copyright)

Published Online: 09-October-2019



Daratumumab is an antibody currently used in the treatment of patients with refractory multiple myeloma. Blood samples from patients being treated with daratumumab may show panreactivity during pre-transfusion testing. To facilitate the provision of blood components for such patients, it is recommended that a baseline phenotype or genotype be established prior to starting treatment with daratumumab. If patient red blood cells (RBCs) require phenotyping after the start of daratumumab treatment, dithiothreitol (DTT) treatment of the patient’s RBCs should be performed. The medical charts of four patients treated with daratumumab were reviewed. The individual number of doses ranged from 1 to 14; patient age ranged from 55 to 78 years; two men and two women were included in the review. Type and screen data were obtained from samples collected over 33 encounters with a range of 1 to 13 encounters per patient. All samples were tested initially by automated solid-phase testing. Any reactivity with solid phase led to tube testing with either low-ionicstrength saline, polyethylene glycol, or both. If incubation failed to eliminate the reactivity, the sample was sent to a reference laboratory for DTT treatment and phenotyping. Of the 33 samples tested, 23 (69.7%) samples had reactivity in solid-phase testing. In 8 of the 10 samples that did not react in solid-phase, testing was conducted more than four half-lives after the last dose of daratumumab. Of the 23 that had reactivity in solid-phase, 16 (69.6%) samples demonstrated loss of reactivity using common laboratory methods. For the seven patients whose sample reactivity was not initially eliminated, six were provided with phenotypically matched blood based on prior molecular testing. Only one sample was sent out for DTT treatment. These results suggest that daratumumab interference with pre-transfusion testing can be addressed using common laboratory methods. This finding could save time and money for laboratories that do not have DTT available.

You don't have 'Full Text' access of this article.

Purchase Article Subscribe Journal Share