CD38单克隆抗体对输血相容性检测干扰及其应对方案的专家共识  

Interference of CD38 monoclonal antibody in blood compatibility testing and its countermeasures:A general consensus among experts

作　　者：糜坚青[1] 蔡晓红[1] 王少元[2] 胡丽华[3] 牛挺[4] 汪德清[5] 傅琤琤[6] 孙春艳[3] 向东[7] 高文[8] 苗天红[9] 钟立业[10] 钱宝华 安刚 夏荣 桂嵘[14] 刘竞[14] 唐晓峰 谢珏[16] 甘佳 吴江[18] 付丹辉 秦莉[4] 侯健 王学锋 MI Jianqing;CAI Xiaohong;WANG Shaoyuan;HU Lihua;NIU Ting;WANG Deqing;FU Chengcheng;SUN Chunyan;XIANG Dong;GAO Wen;MIAO Tianhong;ZHONG Liye;QIAN Baohua;AN Gang;XIA Rong;GUI Rong;LIU Jing;TANG Xiaofeng;XIE Jue;GAN Jia;WU Jiang;FU Danhui;QIN Li;HOU Jian;WANG Xuefeng(Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200000,China;Union Hospital Affiliated to Fujian Medical University;Union Hospital,Tongji Medical Collegey Huazhong University of Science and Technology;West China Hospital,Sichuan University;Department of Blood Transfusion Medicine,First Medical Center,General Hospital of Chinese PLA;Department of Hematology,the First Affiliated Hospital of Suzhou University;Shanghai Blood Center Blood Group Reference Laboratory;Department of Hematology,Beijing Chaoyang Hospital;Institute of Hematology,Beijing Red Cross Blood Center;Department of Hematology,Guangdong Provincial Peopled Hospital;Department of Blood Transfusion,First Affiliated Hospital of Naval Medical University;Department of Hematology,Hematology Institute and Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College;Department of Blood Transfusion,Huashan Hospital,Fudan University;Third Xiangya Hospital,Central South University;Department of Blood Transfusion,Second Affiliated Hospital of Naval Medical University;Department of Blood Transfusion,the First Affiliated Hospital of Medical College of Zhejiang University;Department of Blood Transfusion,Peking Union Medical College Hospitaly Chinese Academy of Medical Sciences;Renji Hospital Affiliated to Medical College of Shanghai Jiaotong University)

机构地区：[1]上海交通大学医学院附属瑞金医院血液科 [2]福建医科大学附属协和医院血液科 [3]华中科技大学同济医学院附属协和医院输血医学科 [4]四川大学华西医院血液科 [5]解放军总医院第一医学中心输血医学科 [6]苏州大学附属第一医院血液科 [7]上海市血液中心血型参比实验室 [8]北京朝阳医院血液科 [9]北京市红十字血液中心血液研究所 [10]广东省人民医院血液科 [11]海军军医大学第一附属医院输血科 [12]中国医学科学院血液学研究所血液病医院血液科 [13]复旦大学附属华山医院输血科 [14]中南大学湘雅三医院输血科 [15]海军军医大学第二附属医院输血科 [16]浙江大学医学院附属第一医院输血科 [17]中国医学科学院北京协和医院输血科 [18]上海交通大学医学院附属仁济医院血液科

出　　处：《中国输血杂志》2021年第4期327-334,共8页Chinese Journal of Blood Transfusion

基　　金：国家自然科学基金面上项目(82070227);上海申康重大临床研究项目(SHDC2020CR2066B、SHDC2020CR2070B)资助。

摘　　要：随着肿瘤免疫靶点的不断发现及抗体研发技术的持续变革,抗体药物在临床上的应用越来越广泛。但有些靶点不仅在肿瘤细胞上表达,而且在红细胞上也有表达,故临床上针对相应靶点抗体的应用可能会对输血相容性检测产生干扰,导致配血困难或输血延迟。本共识总结了目前克服CD38单克隆抗体(简称CD38单抗)干扰输血相容性检测的方法,并经过对不同方法的优缺点分析后,推荐在中国患者人群中使用凝聚胺和巯基还原剂[二硫苏糖醇(Dithiothreitol,DTT)或2-巯基乙醇(2-mercaptoethanol,2-Me)]处理红细胞,作为解决CD38单抗干扰输血相容性检测的方法,以消除CD38单抗带来的输血问题,为临床医师和输血科技术人员提供相应输血前工作流程的解决方案。With continuous discovery of tumor immune targets and continuous changes in antibody research and development technology,antibody drugs are becoming more and more widely used in clinical practice.However,some targets are not only expressed on tumor cells,but also on red blood cells.Therefore,the clinical application of antibodies against the corresponding targets may interfere with the detection of blood transfusion compatibility,resulting in difficulty in blood matching or delay of blood transfusion.This consensus summarizes the current solutions for the interference of CD38 monoclonal antibody(CD38 mAb)in transfusion compatibility testing.After analyzing the advantages and disadvantages of different methods,polybrene and sulfhydryl reducing agents\[dithiothreitol(DTT)or 2-mercaptoethanol(2-Me)\],as a solution for CD38 mAb interference in blood compatibility testing,are recommended for Chinese patients,so as to eliminate blood transfusion interference produce by CD38 mAb and further provide a pre-transfusion workflow for clinicians and technicians in Department of Blood Transfusion.

关 键 词：抗-CD38 单克隆抗体 输血相容性检测 抗体药物干扰 二硫苏糖醇 2-巯基乙醇 

分 类 号：R446.62[医药卫生—诊断学]