{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T18:23:59Z","timestamp":1790533439908,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,6,10]],"date-time":"2019-06-10T00:00:00Z","timestamp":1560124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>CD47 is a novel therapeutic target in the treatment of solid\u2010organ 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\u2010CD47 monoclonal antibody Hu5F9\u2010G4 in relapsed or primary refractory acute myeloid leukemia (AML) (NCT02678338).<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND METHODS<\/jats:title><jats:p>Nineteen patients with relapsed or primary refractory AML treated across five UK centers were included for analysis. Patients received escalating doses of Hu5F9\u2010G4. 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A decline in Hb was observed with drug administration (median Hb change, \u22121.0 g\/dL; range, 0.4\u20131.6) 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\u2010agglutinin identified in plasma. Invalid ABO blood grouping occurred in 4 of 12 (33%) non\u2013group O patients due to anomalous reactivity in the reverse ABO\u2010type results.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Treatment with Hu5F9\u2010G4 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\u2010G4.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.15397","type":"journal-article","created":{"date-parts":[[2019,6,11]],"date-time":"2019-06-11T04:59:41Z","timestamp":1560229181000},"page":"2248-2254","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":103,"title":["The effects of monoclonal anti\u2010CD47 on RBCs, compatibility testing, and transfusion requirements in refractory acute myeloid leukemia"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4028-3733","authenticated-orcid":false,"given":"C.K.","family":"Brierley","sequence":"first","affiliation":[{"name":"Department of Haematology Oxford University Hospitals NHS Foundation Trust  Oxford United Kingdom"},{"name":"MRC Molecular Haematology Unit University of Oxford  Oxford United Kingdom"},{"name":"NIHR Oxford Biomedical Research Centre  Oxford United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Staves","sequence":"additional","affiliation":[{"name":"Department of Haematology Oxford University Hospitals NHS Foundation Trust  Oxford United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford  Oxford United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Oncology Clinical Trials Office (OCTO), Department of Oncology University of Oxford  Oxford United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Vyas","sequence":"additional","affiliation":[{"name":"Department of Haematology Oxford University Hospitals NHS Foundation Trust  Oxford United Kingdom"},{"name":"MRC Molecular Haematology Unit University of Oxford  Oxford United Kingdom"},{"name":"NIHR Oxford Biomedical Research Centre  Oxford United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.T.","family":"Goodnough","sequence":"additional","affiliation":[{"name":"Departments of Pathology and Medicine Stanford University  Stanford California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.F.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Department of Haematology Oxford University Hospitals NHS Foundation Trust  Oxford United Kingdom"},{"name":"NIHR Oxford Biomedical Research Centre  Oxford United Kingdom"},{"name":"National Health Service Blood and Transplant  Oxford United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1121623109"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2009.05.045"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.it.2010.04.001"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm.3965"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.it.2017.12.005"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0137345"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1807315"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2018.36.15_suppl.3002"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2019.37.15_suppl.7009"},{"key":"e_1_2_8_11_1","doi-asserted-by":"crossref","unstructured":"FengD GipP McKennaKM et al.Combination treatment with 5F9 and azacitidine enhances phagocytic elimination of acute myeloid leukemia. Blood2018;132:2729.","DOI":"10.1182\/blood-2018-99-120170"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/1042819042000201989"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.288.5473.2051"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1515969"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13069"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1804751"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15033"},{"key":"e_1_2_8_18_1","doi-asserted-by":"crossref","first-page":"2327","DOI":"10.1182\/blood-2018-99-115674","article-title":"RBC\u2010specific CD47 pruning confers Protection and Underlies the Transient Anemia in Patients Treated with Anti\u2010CD47 Antibody 5F9","volume":"132","author":"Chen J","year":"2018","journal-title":"Blood"},{"key":"e_1_2_8_19_1","unstructured":"U.S. Department of Health and Human Services NIoH National Cancer Institute.Common Terminology Criteria for Adverse Events v4.3 (CTCAE): U.S. Department of Health and Human Services National Institutes of Health National Cancer Institute. 2010. 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Available from:https:\/\/www.eortc.be\/services\/doc\/ctc\/CTCAE_4.03_2010-06-14_QuickReference_5x7.pdf."},{"issue":"3","key":"e_1_2_8_20_1","first-page":"148","article-title":"Interference of anti\u2010CD47 therapy with blood bank testing","volume":"57","author":"Nedelcu E","year":"2017","journal-title":"Transfusion"},{"issue":"3","key":"e_1_2_8_21_1","first-page":"159","article-title":"Serological observations in patients receiving Hu5F9\u2010G4 monoclonal anti\u2010CD47 therapy","volume":"57","author":"Velliquette RW","year":"2017","journal-title":"Transfusion"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V99.10.3500"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1977.tb08818.x"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.15397","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.15397","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.15397","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T21:56:57Z","timestamp":1694296617000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.15397"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,10]]},"references-count":22,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1111\/trf.15397"],"URL":"https:\/\/doi.org\/10.1111\/trf.15397","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,10]]},"assertion":[{"value":"2019-01-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}