The Best CD38 Antibody Depends on the Therapy
Anti-CD38 treatment changes the analytical problem. An antibody that works perfectly at diagnosis may become a poor choice during or after therapy.
By Juan Manuel Ojeda · CFCM
PRIMARY EVIDENCE · PEER-REVIEWED
Primary evidence
Inoue Y, Harada T, Oda A, et al. Selection of anti-CD38 antibodies for flow cytometric detection of myeloma cells treated with daratumumab or isatuximab. International Journal of Hematology. 2026;124(2):204–214. DOI: 10.1007/s12185-026-04210-5.
What it actually demonstrates
The JK36 anti-CD38 VHH antibody gave clearer CD38 detection in daratumumab-treated myeloma cells, whereas conventional anti-CD38 monoclonal antibodies performed better after isatuximab exposure. The pattern was also examined in primary marrow samples from treated patients.
Evidence boundary
The accessible abstract supports therapy-aware clone selection. It does not provide the primary-patient sample total or establish a universal best reagent, a clinical MRD detection limit, or equivalence across laboratories. Published online 13 April 2026; print issue August 2026.
Primary record →CD38 is a useful plasma-cell marker, but therapeutic antibodies such as daratumumab and isatuximab can interfere with detection depending on the diagnostic clone and epitope. That means clone selection is not simply a reagent preference; it becomes part of assay validation.
For laboratories monitoring plasma-cell disorders, validation should explicitly include treated samples or appropriate surrogates, alternative plasma-cell markers and a defined strategy for loss or masking of CD38. The clinically correct antibody is therefore context-dependent.
This is a broader lesson for clinical flow cytometry: targeted therapy can change the phenotype we are trying to measure. Panels designed before therapy should not automatically be assumed to remain fit for purpose afterwards.
CFCM view
The important question is not whether the technology or marker is interesting. It is whether it changes a validated clinical workflow in a measurable, reproducible and explainable way.
CFCM is an independent publication. References to manufacturers, instruments, reagents, software or therapies do not constitute endorsement. Technical content should be interpreted in the context of local validation, applicable regulation and manufacturer instructions for use.