Zhou Ye, Chen Leiyu, Jiang Tianshu, Fan Liangfeng, Lei Hang, Wang Yuqing, Heililahong Hasiyati, Mi Jianqing, Du Danxin, Miao Tianhong, Xia Rong, Wang Xuefeng, Xiang Dong, Cai Xiaohong, Tang Xiaofeng
Department of Blood Transfusion, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China.
Blood Group Reference Laboratory, Shanghai Blood Center, Shanghai, People's Republic of China.
Hematology. 2021 Dec;26(1):365-370. doi: 10.1080/16078454.2021.1918916.
Treating red blood cells (RBCs) with dithiothreitol (DTT) is a wildly-recommended to overcome the interference of the daratumumab (DARA) with blood compatibility testing. Nevertheless, DTT can be hard to obtain in the clinical laboratory, while its use in routine practice may be time-consuming. In the following study, we explored the feasibility of using a commercial 2-mercaptoethanol (2-ME) working solution or the time-saving Polybrene method to mitigate DARA interference.
Antibody screening and cross-matching were performed using 2-ME or DTT-based indirect antiglobulin tests (IATs) and Polybrene method (with human IgG anti-E same IATs titer as DARA as positive control) on 37 samples. Most clinically important blood group antigens on RBCs were detected after treatment with 2-ME or DTT.
Treating RBCs with 2-ME eliminates the DARA interference with the antibody screening or cross-matching; yet, K antigen is denatured during treatment. DARA does not interfere with antibody screening and cross-matching via Polybrene method, while 2+ agglutinations of anti-E antibody with the same titer (IATs method) as DARA could be observed in the positive controls via this method.
2-ME-based IATs or Polybrene method could replace DTT-based IATs to mitigate DARA interference.
用二硫苏糖醇（DTT）处理红细胞（RBC）是一种广泛推荐的克服达雷妥尤单抗（DARA）对血型相容性检测干扰的方法。然而，DTT在临床实验室中可能难以获得，且在常规操作中使用可能耗时。在以下研究中，我们探讨了使用市售的2-巯基乙醇（2-ME）工作溶液或省时的聚凝胺方法减轻DARA干扰的可行性。
对37份样本使用基于2-ME或DTT的间接抗球蛋白试验（IAT）和聚凝胺方法（以与DARA具有相同IAT效价的人IgG抗-E作为阳性对照）进行抗体筛查和交叉配血。在用2-ME或DTT处理后检测RBC上大多数临床上重要的血型抗原。
用2-ME处理RBC可消除DARA对抗体筛查或交叉配血的干扰；然而，K抗原在处理过程中会变性。DARA不会通过聚凝胺方法干扰抗体筛查和交叉配血，而通过该方法在阳性对照中可观察到与DARA具有相同效价（IAT方法）的抗-E抗体出现2+凝集。
基于2-ME的IAT或聚凝胺方法可替代基于DTT的IAT来减轻DARA干扰。
