Anti-CD38 therapy

[David Saikin]

Looking for opinions.  If after base line testing and monitoring w DTT treated absc at reference lab.  Anyone see a reason why we couldn't just perform immediate spin xm if there is no evidence of sensitization.  (I'd also like to do this with WAIHA pts who show no alloimmunizations).

[exlimey]

An interesting position; in practice, it would probably work fine. I am not a regulatory expert, but I thought that both IS crossmatches and electronic crossmatches are only permissible after a negative antibody screen. Obviously in the DARA/anti-CD38 cases this would not be so. You may be able to wordsmith your way around the constraint.

[JoyG]

We consider Anti-DARA/CD-38 as a clinically INsignificant antibody.  Computer will allow ISXM/ELXM if current ABSC is negative and AB is insignificant and the workup is complete with no other underlying clinically significant antibodies.  We've had about 25 patients and transfused multiple times over the course of the year with no adverse events.

[Joanne P. Scannell]

No Clinically Significant Allo-Antibodies = No Extended Crossmatch (what are you expecting up there other than the same insignificant mess, e.g. DARA, WARM AUTO?).

In Sunquest, we enter the code %CINS for the Antibody Screen (%AS).  This was 'invented' (by Sunquest) for this situation ... so electronic crossmatches are possible.

We enter %POS for %AS only if we find 'Clinically Significant Allo-Antibodies' ... and then we do Extended Crossmatches.