CMFreeman

I'm working at the MD Anderson blood bank here in Houston now and we see this pretty regularly - at least 10/week easily. Probably because we treat a lot of myeloma patients that have been through multiple standard regimens elsewhere. Its in our standard instructions now to look at drug history for Dara if we see the patient has multiple myeloma. Usual pattern after a recent dose is for screens and panels to have no reactivity at 37, micro pos or 1+ at AHG, and about the same with ficin treated cells. A/C is Usually negative (I'd estimate maybe 75% of the time), but occasionally will be micro Pos at AHG, same strength DAT, and elution will be negative. Crossmatches usually show micro pos incompatibility, so we end up doing a lot of pathologist approvals for "least incompatible units". We use the Bioarray instrument for patient genotyping on these, so we can do antigen matching in future if the pathologist decides its warranted. We are starting parallel testing with DTT treated panels soon so we wont be essentially transfusing blind anymore. The sales pitch does make it sound simple, but experience will tell.