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BES

daratumumab

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What is your policy for transfusion after the treatment is completed and the antibody screen is negative, again. Sorry the treatment is Daratumumab.

Edited by BES
missing treatment

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Once the interfering drug is gone, we would treat them like a usual patient with a negative antibody screen.  One caveat is that our BBIS won't allow an EXM for any patient who has ever had a positive antibody screen reported.  If we ever reported the initial screen as positive instead of the DTT-treated screen (negative, I hope) we would have to do future XMs by IS rather than EXM.  If we knew the patient would go back on it, I suppose we might give K negative units but most that I have seen go off of it didn't go back on and, frankly, most expired within a few months.  This experience is mostly from the early days when it was only approved as a last resort therapy so now less refractory patients are taking the drug and may have different outcomes.

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We give antigen-matched units when the patient is on Darzelex so they hopefully wouldn't build any antibodies.  Would you continue that when the screen was once again negative, or would you just select any compatible unit?

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3 hours ago, TreeMoss said:

We give antigen-matched units when the patient is on Darzelex so they hopefully wouldn't build any antibodies.  Would you continue that when the screen was once again negative, or would you just select any compatible unit?

Any comparable unit. 

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We give antigen matched blood during the treatment of Darzelex (Daratumumab) and after treatment Kell negative, if patient typed K negative. I totally agree with the policy of Mabel Adams thread to go back to e-match or IS units after treatment with a negative antibody screen.

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