Utility of chloroquine diphosphate in the blood bank laboratory

Aye, T.; Arndt, P.A.

doi:10.21307/immunohematology-2018-016

Abstract

Chloroquine diphosphate (CDP) is a helpful tool in the blood bank for two main applications. The most common application is to render direct antiglobulin test–positive red blood cells (RBCs) free from membrane-bound IgG; these treated RBCs can then be used for autologous adsorption and/or to determine the patient’s RBC phenotype. Another common use of CDP is to remove human leukocyte antigens (HLAs) from RBCs to help identify or exclude the presence of antibodies to HLAs expressed on RBCs, for example, Bennett-Goodspeed (Bg) antigens. In this review, the principles, applications, and limitations of using CDP are discussed. Immunohematology 2018;34:98–102.

References

Rodberg K, Tsuneta R, Garratty G. Discrepant Rh phenotyping results when testing IgG-sensitized RBCs with monoclonal Rh reagents (abstract). Transfusion 1995;35(Suppl):67S.
Search in Google Scholar Back to article
Lee E, Hart K, Burgess G, et al. Efficacy of murine monoclonal antibodies in RBC phenotyping of DAT-positive samples. Immunohematology 2006;22:161–5.10.21307/immunohematology-2019-375
Search in Google Scholar Back to article
DePalma H, Lomas-Francis C, Wilson-Sandberg K, et al. Unexpected antigen typing discrepancies in testing of DAT+ RBCs with monoclonal reagents (abstract). Transfusion 2017;57(Suppl S3):37A.
Search in Google Scholar Back to article
Holtz G, Mantel W, Buck W. The inhibition of antigen-antibody reactions by chloroquine and its mechanism of action. Z Immunitatsforsch Exp Klin Immunol 1973;146:145–57.
Search in Google Scholar Back to article
Mantel W, Holtz G. Characterisation of autoantibodies to erythrocytes in autoimmune haemolytic anaemia by chloroquine. Vox Sang 1976;30:453–63.10.1111/j.1423-0410.1976.tb02851.x1274288
Search in Google Scholar Back to article
Edwards JM, Moulds JJ, Judd WJ. Chloroquine dissociation of antigen-antibody complexes: a new technique for typing red cells with a positive antiglobulin test. Transfusion 1982;22: 59–61.10.1046/j.1537-2995.1982.22182154219.x6801829
Search in Google Scholar Back to article
Widmann FK, Ed. AABB technical manual. 8th ed. Philadelphia, PA: JB Lippincott, 1981.
Search in Google Scholar Back to article
Branch DR, Petz LD. A new reagent (ZZAP) having multiple applications in immunohematology. Am J Clin Pathol 1982; 78:161–7.10.1093/ajcp/78.2.1616808844
Search in Google Scholar Back to article
Petz LD, Garratty G. Acquired immune hemolytic anemia. New York: Churchill Livingstone, 1980.
Search in Google Scholar Back to article
Louie JE, Jiang AF, Zaroulis CG. Preparation of intact antibody-free red blood cells in autoimmune hemolytic anemia (abstract). Transfusion 1986;26:550.
Search in Google Scholar Back to article
Kosanke J. EDTA glycine acid treatment of red blood cells. Immunohematology 2012;28:95–6.10.21307/immunohematology-2019-157
Search in Google Scholar Back to article
McCullough JS, Torloni AS, Brecher ME, et al. Microwave dissociation of antigen-antibody complexes: a new elution technique to permit phenotyping of antibody-coated red cells. Transfusion 1993;33:725–9.10.1046/j.1537-2995.1993.33994025021.x8212118
Search in Google Scholar Back to article
Swanson JL, Sastamoinen R. Chloroquine stripping of HLA A,B antigens from red cells (letter). Transfusion 1985;25: 439–40.10.1046/j.1537-2995.1985.25586020120.x3863353
Search in Google Scholar Back to article
Champagne K, Spruell P, Chen J, et al. EDTA/glycine-acid versus chloroquine diphosphate treatment for stripping Bg antigens from red blood cells. Immunohematology 1999; 15:66–8.10.21307/immunohematology-2019-615
Search in Google Scholar Back to article
Gamma-Quin. Manufacturer’s instructions. Norcross, GA: Immucor, 2013.
Search in Google Scholar Back to article
Issitt PD, Anstee DJ. Applied blood group serology. 4th ed. Durham, NC: Montgomery Scientific, 1998.
Search in Google Scholar Back to article
Burich MA, AuBuchon JP, Anderson HJ. Evaluation of rapid antibody dissociation techniques. Immunohematology 1986;2:76–80.
Search in Google Scholar Back to article
Burin des Roziers N, Squalli S. Removing IgG antibodies from intact red cells: comparison of acid and EDTA, heat and chloroquine elution methods. Transfusion 1997;37:497–501.10.1046/j.1537-2995.1997.37597293880.x9149774
Search in Google Scholar Back to article
Sererat TS, Veidt D, Dutched A. A quick and simple method for phenotyping IgG-sensitized red blood cells. Immunohematology 2000;16:154–6.10.21307/immunohematology-2019-598
Search in Google Scholar Back to article
Katharia R, Chaudhary RK. Removal of antibodies from red cells: comparison of three elution methods. Asian J Transfus Sci 2013;7:29–32.10.4103/0973-6247.106727361365723559761
Search in Google Scholar Back to article
Sassetti R, Nichols D. Decreased antigenic reactivity caused by chloroquine (letter). Transfusion 1982;22:537. Moulds JJ, Edwards JM, Judd WJ (response). Transfusion 1982;22: 537–8.10.1046/j.1537-2995.1982.22683068623.x6183803
Search in Google Scholar Back to article
Prewitt PL, Steane EA, Steane SM. Decreased agglutinability with anti-D of chloroquine-treated red cells (abstract). Transfusion 1983;23:434.
Search in Google Scholar Back to article
Chen J, Spruell P, Moulds M. Studies using chloroquine diphosphate to strip HLA A and B antigens from red blood cells (RBCs). ISBT/AABB Book of Abstracts 1990;152.
Search in Google Scholar Back to article
Beaumont AE, Stamps R, Booker DJ, Sokol RJ. An improved method for removal of red cell-bound immunoglobulin using chloroquine solution. Immunohematology 1994;10:22–4.10.21307/immunohematology-2019-815
Search in Google Scholar Back to article
Reid ME, Lomas-Francis C, Olsson ML. The blood group antigen factsbook. San Diego, CA; Academic Press, 2012.10.1016/B978-0-12-415849-8.00026-0
Search in Google Scholar Back to article
Mallory D, Reid M. Misleading effects of chloroquine (letter). Transfusion 1984;24:412.10.1046/j.1537-2995.1984.24585017834.x6485085
Search in Google Scholar Back to article
Shin C, Mallory D, Reid M. False negative red cell antigen typing following chloroquine treatment (abstract). Transfusion 1984;24:416.
Search in Google Scholar Back to article
Brazell J. Use of monoclonal Jk(a) and Jk(b) reagents in phenotyping red cells with a positive direct antiglobulin test. Immunohematology 1994;10:16–8.10.21307/immunohematology-2019-813
Search in Google Scholar Back to article
McShane K, Cornwall S. Chloroquine reduces antigen strength (letter). Transfusion 1985;25:83.10.1046/j.1537-2995.1985.25185116513.x3969708
Search in Google Scholar Back to article
Leger RM, Garratty G. A reminder that ZZAP reagent removes complement in addition to IgG from coated RBCs. Immunohematology 2006;22:205–6.
Search in Google Scholar Back to article

Utility of chloroquine diphosphate in the blood bank laboratory

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