Journal article
The effects of monoclonal anti‐CD47 on RBCs, compatibility testing, and transfusion requirements in refractory acute myeloid leukemia
- Abstract:
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BACKGROUND
CD47 is a novel therapeutic target in the treatment of solid‐organ and hematologic malignancies. CD47 is also expressed on RBCs. Here, we report our experience of the RBC effects and the impact on blood bank testing and transfusion management in a Phase 1 trial of the humanized anti‐CD47 monoclonal antibody Hu5F9‐G4 in relapsed or primary refractory acute myeloid leukemia (AML) (NCT02678338).
STUDY DESIGN AND METHODS
Nineteen patients with relapsed or primary refractory AML treated across five UK centers were included for analysis. Patients received escalating doses of Hu5F9‐G4. Serial laboratory data were collected to evaluate impact on hemoglobin (Hb), markers of hemolysis (bilirubin, lactate dehydrogenase, reticulocyte count), transfusion requirements, and blood compatibility testing.
RESULTS
A decline in Hb was observed with drug administration (median Hb change, −1.0 g/dL; range, 0.4–1.6) with associated increase in transfusion requirements. Patients responded to transfusion with a median Hb increment per unit of 1.0 g/dL. RBC agglutination was seen in all cases without associated change in Hb, lactate dehydrogenase, bilirubin, or reticulocyte count. Nine of 19 (47%) patients developed a newly positive antibody screen with a pan‐agglutinin identified in plasma. Invalid ABO blood grouping occurred in 4 of 12 (33%) non–group O patients due to anomalous reactivity in the reverse ABO‐type results.
CONCLUSIONS
Treatment with Hu5F9‐G4 in patients with AML resulted in an Hb decline and increased transfusion requirements. Problems with ABO blood typing and compatibility testing were widely observed and should be expected by centers treating recipients of Hu5F9‐G4.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Accepted manuscript, pdf, 645.8KB, Terms of use)
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- Publisher copy:
- 10.1111/trf.15397
Authors
- Publisher:
- Wiley
- Journal:
- Transfusion More from this journal
- Volume:
- 59
- Issue:
- 7
- Pages:
- 2248-2254
- Publication date:
- 2019-06-10
- Acceptance date:
- 2019-04-01
- DOI:
- EISSN:
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1537-2995
- ISSN:
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0041-1132
- Pmid:
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31183877
- Language:
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English
- Keywords:
- Pubs id:
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pubs:1012664
- UUID:
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uuid:3822e025-6475-4585-9b1c-424ab04d51a0
- Local pid:
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pubs:1012664
- Source identifiers:
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1012664
- Deposit date:
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2019-06-25
- ARK identifier:
Terms of use
- Copyright holder:
- AABB
- Copyright date:
- 2019
- Rights statement:
- © 2019 AABB.
- Notes:
- This is the accepted manuscript version of the article. The final version is available online from Wiley at: https://doi.org/10.1111/trf.15397
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