Case 130 – update 2

We have delved deeper into our 54 year old patient’s history and, as many of you guessed, he takes daratumumab for multiple myeloma. We have discussed with his clinical team and agreed to hold off transfusion until we can perform more serological tests.

As you have suggested, we sent his sample to NHSBT and they have treated the reagent RBCs with dithiothreitol (DTT) and repeated an antibody screen:

B30114D5-8970-4577-A98D-4AA6E3659194

We have no previous G&S sample for this patient. From our forward/reverse group we known he is group AB Rh D-ve. He has a likely NSTEMI with an Hb of 78 and so the clinical team wish to transfuse.

What does the enzyme panel show? How does this work with daratumumab?

Are there any further tests required pre-transfusion?

What red blood specifications would you use to transfuse?

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