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.
 
 

I am winding up 43 years of blood banking on Friday. I will still drop in to PathLabTalk from time to time but I'm not sure how frequently that will be. I would like to thank all of our BB Talk family for sharing their knowledge, insights, advice, hints, constructive criticism and everything else that makes this site so wonderful to us BB geeks. I would particularly like to thank Cliff, without whom this site would not exist, and Malcolm, for being himself, a consummate blood banker and consummate gentleman (even when he's dressed in my pajama bottoms - but that's another story!)