From the Guidelines
Type and screen is the recommended initial test for patients who may require a blood transfusion, especially for those receiving daratumumab, as it informs future matching and is sufficient for cases where transfusion is possible but not definitely required. According to the NCCN Panel, performing type and screen prior to receiving daratumumab is recommended to inform future matching 1. This is because daratumumab can interfere with cross-matching and red blood cell antibody screening.
Key Considerations
- Type and screen is a blood test that identifies a patient's blood type and screens for antibodies, typically ordered when there's a possibility that a patient might need a blood transfusion, but transfusion isn't immediately planned.
- Type and cross is a more comprehensive test that includes the type and screen plus a crossmatch to ensure compatibility between donor blood and recipient, ordered when a blood transfusion is anticipated.
- The choice between these tests depends on the clinical scenario, with type and cross being necessary when transfusion is likely needed and type and screen being sufficient for cases where transfusion is possible but not definitely required.
Clinical Implications
- In patients receiving daratumumab, type and screen is preferred as the initial test to inform future matching 1.
- Type and cross may be necessary in certain clinical scenarios where transfusion is likely needed, but type and screen is sufficient for cases where transfusion is possible but not definitely required.
- The NCCN Panel recommends performing type and screen prior to receiving daratumumab to inform future matching, highlighting the importance of this test in patients receiving this medication 1.
From the Research
Type and Screen vs Type and Cross
- The main difference between type and screen and type and cross is the level of testing performed to ensure compatibility between the donor blood and the recipient's blood 2.
- Type and screen involves testing the recipient's blood for ABO group and Rh type, as well as screening for any antibodies that may react with donor blood 2.
- Type and cross, on the other hand, involves cross-matching the donor blood with the recipient's blood to ensure compatibility, in addition to the type and screen testing 3.
- The choice between type and screen and type and cross depends on the clinical situation and the patient's specific needs, with type and cross being more commonly used in emergency situations or when there is a high risk of transfusion reaction 4.
- Studies have shown that type and screen is sufficient for most transfusions, but type and cross may be necessary in certain situations, such as when a patient has a history of transfusion reactions or when the donor blood is not readily available 5.
Advantages and Disadvantages
- Advantages of type and screen include:
- Faster turnaround time
- Lower cost
- Reduced risk of transfusion reaction due to clerical error
- Disadvantages of type and screen include:
- May not detect all potential transfusion reactions
- May not be suitable for patients with complex transfusion histories
- Advantages of type and cross include:
- Provides an additional layer of safety by cross-matching the donor blood with the recipient's blood
- May be necessary in emergency situations or when there is a high risk of transfusion reaction
- Disadvantages of type and cross include:
- Slower turnaround time
- Higher cost
- May not be necessary for all transfusions, which can lead to unnecessary delays and costs 6.
Clinical Implications
- The choice between type and screen and type and cross should be based on the individual patient's needs and the clinical situation 2.
- Clinicians should be aware of the advantages and disadvantages of each approach and use their judgment to determine the best course of action 3.
- Further research is needed to determine the optimal approach for different clinical situations and patient populations 4, 5.