Alternative Sampling Devices to Collect Dried Blood Microsamples: State-of-the-Art

Abstract

Dried blood spots (DBS) have been used in newborn screening programs for several years. More recently, there has been growing interest in using DBS as a home sampling tool for the quantitative determination of analytes. However, this presents challenges, mainly because of the well-known hematocrit effect and other DBS-specific parameters, including spotted volume and punch site, which could add to the method uncertainty. Therefore, new microsampling devices that quantitatively collect capillary dried blood are continuously being developed. In this review, we provided an overview of devices that are commercially available or under development that allow the quantitative (volumetric) collection of dried blood (-based) microsamples and are meant to be used for home or remote sampling. Considering the field of therapeutic drug monitoring (TDM), we examined different aspects that are important for a device to be implemented in clinical practice, including ease of patient use, technical performance, and ease of integration in the workflow of a clinical laboratory. Costs related to microsampling devices are briefly discussed, because this additionally plays an important role in the decision-making process. Although the added value of home sampling for TDM and the willingness of patients to perform home sampling have been demonstrated in some studies, real clinical implementation is progressing at a slower pace. More extensive evaluation of these newly developed devices, not only analytically but also clinically, is needed to demonstrate their reallife applicability, which is a prerequisite for their use in the field of TDM.

Therapeutic Drug Monitoring of Tyrosine Kinase Inhibitors Using Dried Blood Microsamples

“…New devices, allowing an accurate volumetric collection of capillary dried blood microsamples, are continuously being developed. These maintain the benefits associated with DBS, while avoiding the above-described Hct-based area bias ( 66 ). One of the first strategies to achieve this is VAMS, which has evolved over the course of years into a valuable alternative to classical DBS sampling.…”

“…To date, two groups have investigated the measurement of TKIs using VAMS, establishing multi-analyte methods for the simultaneous quantification of eight ( 35 ) or ten TKIs ( 46 ). Other volumetric microsampling devices avoiding the Hct and inhomogeneity bias include the HemaPEN (Trajan, Melbourne, Australia), Capitainer qDBS (Capitainer, Solna, Sweden) and HemaXis DB 10 (HemaXis, Gland, Switzerland) device ( 66 ). To the best of our knowledge, none of these devices has been used for the determination of TKIs yet.…”

“…A drawback associated with these alternative sampling devices is the higher cost and, for some, the more complex sampling and processing technique compared to conventional DBS. These aspects, together with the recency of these developments, may explain the hitherto limited implementation of these devices in clinical routine ( 66 ).…”

The Evolving Role of Microsampling in Therapeutic Drug Monitoring of Monoclonal Antibodies in Inflammatory Diseases

“…Additionally, a 4.6% of patients encountered problems in clearly observing the device, due to impaired vision. However, the patients only received brief guidelines on how to obtain the samples themselves, which may justify their problems [91].…”

Therapeutic Drug Monitoring of Antiseizure Medications Using Volumetric Absorptive Microsampling: Where Are We?

“…Since the withdrawal can be made in the absence of qualified personnel, it allows for sample collection at home. Today, VAMS ® may represent a very promising microsampling technique (reviewed in [ 14 , 15 , 16 ]) (a complete list of published papers involving VAMS ® use can be found in [ 17 ]). As discussed in ref [ 12 ] and [ 13 ] VAMS ® are reliable tools for pharmacokinetic and toxicokinetic studies.…”