Effect of anti-CD38 monoclonal antibody on cross matching interference and transfusion efficacy in patients with multiple myeloma
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摘要: 目的 多发性骨髓瘤(MM)患者应用抗CD38单克隆抗体治疗，影响红细胞(RBC)交叉配血结果，评估经二硫苏糖醇(DTT)处理RBC后交叉配血的结果及输血疗效。方法 对40例使用抗-CD38单克隆抗体治疗的MM患者血浆与经DTT处理后的供者RBC、抗筛细胞及自身细胞进行交叉配血，并对其输血前后实验室指标进行统计分析。结果 40例患者输注RBC后血红蛋白、血细胞比容和RBC[(75.60±11.80) g/L，(22.39±3.53)%，(2.46±0.42)×1012/L]比输血前[(66.60±10.47) g/L，(19.81±3.10)%，(2.15±0.38)×1012/L]明显提高，差异有统计学意义(P< 0.01);患者总胆红素、直接胆红素、间接胆红素及乳酸脱氢酶输注前后差异无统计学意义(P>0.05)。患者输血有效率为62.5%，部分有效率为20.0%，无效率为17.5%。结论 DTT处理RBC对使用抗CD38单克隆治疗的MM患者配血不相合有效，经这种配血方法选择RBC为患者输注，其实验室指标表明输血疗效较为明显。
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关键词:
- 抗CD38单克隆抗体 /
- 多发性骨髓瘤 /
- 输血 /
- 二硫苏糖醇
Abstract: Objective After treatment with anti-CD38 monoclonal antibody in patients with multiple myeloma(MM), it affects the results of red blood cell cross-matching. In this study, we evaluate the results of blood cross-matching after dithiothreitol(DTT) treatment of red blood cells and the efficacy of blood transfusion.Methods The plasma of 40 MM patients treated with anti-CD38 monoclonal antibody was cross-matched with donor red blood cells, anti-screening cells and autologous cells after DTT treatment, and the laboratory indicators before and after transfusion were statistically analyzed.Results The hemoglobin value, hematocrit, red blood cell count of these 40 patients after erythrocyte transfusion were significantly higher than those before blood transfusion([66.60±10.47]g/L, [19.81±3.10]%, [2.15±0.38]×1012/L vs [75.60±11.80]g/L, [22.39±3.53]%, [2.46±0.42]×1012/L), with a statistically significant difference(P< 0.01); there were no significant difference between before and after transfusion of the total bilirubin, direct bilirubin, indirect bilirubin, and lactate dehydrogenase, and there was no statistical significance(P>0.05). The patient's blood transfusion had an effective rate of 62.5%, partial effective rate of 20.0%, and inefficiency of 17.5%.Conclusion DTT treatment of red blood cells was effective for the blood matching of MM patients treated with anti-CD38 monoclonal antibodies. The red blood cells selected by this blood distribution method can be infused into patients. The increase in hemoglobin and the amount of red blood cells in the infused body are basically consistent, the transfusion effect is obvious.-
Key words:
- anti-CD38 monoclonal antibody /
- multiple myeloma /
- transfusion /
- dithiothreitol
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表 1 患者输血前后实验室指标比较
X±S 时间 Hb/(g·L-1) HCT/% RBC计数/(×1012·L-1) 总胆红素/(μmol·L-1) 直接胆红素/(μmol·L-1) 间接胆红素/(μmol·L-1) 乳酸脱氢酶/(U·L-1) 输血前 66.60±10.47 19.81±3.10 2.15±0.38 10.77±3.87 3.18±2.14 7.89±3.51 193.50±96.13 输血后 75.60±11.801) 22.39±3.531) 2.46±0.421) 11.85±5.58 3.33±2.15 11.05±16.54 197.74±127.38 t 9.936 9.707 11.165 1.498 0.431 1.318 0.181 与输血前比较，1)P < 0.01。 
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