抗CD38单抗治疗多发性骨髓瘤的抗体鉴定策略  

Strategies for identification of antibody in multiple myeloma patients treated with anti-CD38 MoAb

作　　者：邹昕 范小杰[2] 虞茜 许飞[1] 杨红梅[1] ZOU Xin;FAN Xiaojie;YU Xi;XU Fei;YANG Hongmei(Transfusion Research Laboratory,Changzhou Blood Center,Chang-zhou 213004,Jiangsu;Department of Clinical Laboratory,Changzhou First People's Hospital,Changzhou 213004,Jiangsu,China)

机构地区：[1]常州市中心血站输血研究室,江苏常州213004 [2]常州市第一人民医院检验科,江苏常州213004

出　　处：《临床检验杂志》2023年第1期56-59,共4页Chinese Journal of Clinical Laboratory Science

基　　金：常州市青年科技人才项目(QN202133);常州市中心血站科研基金(XZ202107);常州市科技局项目(CJ20220240)。

摘　　要：目的分析经抗CD38单抗治疗的多发性骨髓瘤患者的抗体并探索鉴定策略。方法选取2019年11月至2021年6月用抗CD38单抗治疗且配血不合的30例多发性骨髓瘤患者作为研究对象。用0.2 mol/L二硫苏糖醇(DTT)处理的谱细胞对患者血清标本进行抗体特异性鉴定;对有自身抗体的患者用血清倍比稀释法鉴别同种抗体及自身抗体;于第1、7、14、28、35天监测DTT处理后的红细胞在生理盐水和血型分析用稀释液中的游离血红蛋白浓度。结果用DTT处理的谱细胞鉴定发现,24例均为阴性;1例检出抗E同种抗体合并自身抗体;5例检出自身抗体。利用倍比稀释法确认,4例自身抗体没有特异性,1例检出类抗C自身抗体。生理盐水组与血型分析用稀释液组游离血红蛋白浓度随贮存时间延长不断上升,两组差异有统计学意义(P<0.05)。结论经抗CD38单抗治疗的多发性骨髓瘤患者,建议用DTT处理的谱细胞合并血清倍比稀释法快速初步鉴别同种抗体、自身抗体以及CD38单抗干扰;血型分析用稀释液可以用于保存DTT处理的谱细胞。Objective To analyze the antibodies in the multiple myeloma patients treated with anti-CD38 MoAb antibodies and explore the strategies for identification of antibodies.Methods A total of 30 patients with multiple myeloma who were treated with anti-CD38 MoAb and exhibited crossmatching incompatibility from November 2019 to June 2021 were selected as the study subjects.0.2 mol/L di-thiothreitol(DTT)-treated profiling cells were used to identify the specificity of various antibodies in the studied serum samples.The se-rum of the patients with autoantibodies were identified by multiple dilution method.The concentrations of free hemoglobin in normal sa-line and diluent for blood group analysis were monitored on the day 1,7,14,28 and 35.Results The identification for profiling cells treated with DTT revealed that none was detected as positive antibodies in the 24 cases.Anti-E alloantibodies combined with autoanti-bodies were detectable in 1 case.Autoantibodies were detectable in 5 cases who were conformed by diluted serum.Among them,4 ca-ses showed no andibody-related specificity,and one mimicked the specificity of anti-C antibody.The concentrations of free hemoglobin in both saline group and diluent group showed increased trend with the prolongation of storage time,but the difference between the two groups showed statistically significant.Conclusion DTT-treated spectrum cells combined with serum dilution method can be used to i-dentify the alloantibodies,autoantibodies quickly and easily in the multiple myeloma patients who were treated with anti-CD38 MoAb.The diluents for blood group analysis can be used to preserve the DTT-treated spectrum cells.

关 键 词：抗CD38单抗 自身抗体 二硫苏糖醇 同种抗体 

分 类 号：R446[医药卫生—诊断学]