抗CD-38和抗CD-47单抗药物对输血相容性检测的干扰与应对策略研究进展*

doi:10.3969/j.issn.1671-2587.2023.04.026

临床输血与检验 ›› 2023, Vol. 25 ›› Issue (4): 559-563.DOI: 10.3969/j.issn.1671-2587.2023.04.026

抗CD-38和抗CD-47单抗药物对输血相容性检测的干扰与应对策略研究进展^*

王斐^1,2, 陈要臻², 胡兴斌²

¹西安医学院; ²第四军医大学西京医院输血科,陕西西安 710032

收稿日期:2023-06-02 出版日期:2023-08-20 发布日期:2023-09-18
通讯作者: 胡兴斌,男,博士生导师,副教授,主要从事输血医学研究工作,（E-mail）hxbyqh@163.com。
作者简介:王斐,主要从事输血医学研究工作,（E-mail）2389140068@qq.com。
基金资助:
*本课题受陕西省卫生健康科研创新能力提升项目（No.2023TD-03）,西京医院临床高新技术项目（No.XJGX16CG26）资助

Monoclonal Anti-CD38 and Anti-47 Interference and Strategies in Compatibility Testing

WANG Fei, CHEN Yaozhen, HU Xingbin, et al

Xi'an Medical University, Xi'an 710032

Received:2023-06-02 Online:2023-08-20 Published:2023-09-18

摘要/Abstract

摘要： 近年来,以免疫检查点相关信号通路为靶点的新型单抗药物在肿瘤治疗领域显示出了强大潜力。新近研发的Hu5F9-G4、IBI188、Daratumumab均是分别以CD47、CD38为治疗靶点制备的单抗类药物,这些药物在治疗淋巴瘤、多发性骨髓瘤或其他恶性肿瘤方面,显示出了特异性高、临床疗效好等优点。但是CD38和CD47分子不仅表达在肿瘤细胞上,在人红细胞上也有表达,因此经抗-CD38和抗-CD47单抗药物治疗的患者,会因为血液中存在抗-CD38或抗-CD47抗体与红细胞特异性结合,而导致血型鉴定、交叉配血和不规则抗体等输血相容性检测出现假阳性,威胁输血安全。本文阐述了目前抗-CD38单抗和抗-CD47单抗药物对输血相容性检测存在的干扰问题和现有排除策略,为最大限度降低抗-CD38单抗和抗-CD47单抗药物对输血安全造成的影响提供参考。

关键词: 单克隆抗体药物, CD38, CD47, 输血相容性检测

Abstract: More recently, novel monoclonal antibodies targeting immune checkpoints related signaling pathways have shown promise in the field of cancer immunotherapy. Hu5F9-G4, IBI188, and Daratumumab, designed specifically to target CD47 and CD38, have demonstrated clinical efficacy in patients with lymphoma, multiple myeloma, and other malignancies. Because CD38 and CD47 molecules are expressed not only on tumor cells, but also on red blood cells, anti-CD38 or anti-CD47 antibodies are specifically bound to red blood cells in the blood of patients treated with anti-CD38 and anti-CD47 monoclonal drugs. This leads to false positives in compatibility testing, such as blood typing, cross-matching and irregular antibody screening etc., which poses a risk to transfusion safety. In this paper, the interference problems of anti-CD38 and anti-CD47 on blood transfusion compatibility testing and the existing elimination strategies are described to provide reference for minimizing the impact of anti-CD38 and anti-CD47 on blood transfusion safety.

Key words: Monoclonal antibody drugs, CD38, CD47, Compatibility testing

中图分类号:

R457

王斐, 陈要臻, 胡兴斌. 抗CD-38和抗CD-47单抗药物对输血相容性检测的干扰与应对策略研究进展^*[J]. 临床输血与检验, 2023, 25(4): 559-563.

WANG Fei, CHEN Yaozhen, HU Xingbin, et al. Monoclonal Anti-CD38 and Anti-47 Interference and Strategies in Compatibility Testing[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2023, 25(4): 559-563.

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抗CD-38和抗CD-47单抗药物对输血相容性检测的干扰与应对策略研究进展^*

Monoclonal Anti-CD38 and Anti-47 Interference and Strategies in Compatibility Testing

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