GHEVAERT, Cedric, CAMPBELL, Kate, STAFFORD, Prachi, METCALFE, Paul, CASBARD, Angela, SMITH, Graham A, ALLEN, Dave, RANASINGHE, Edmund, WILLIAMSON, Lorna M and OUWEHAND, Willem H (2007). HPA-1a antibody potency and bioactivity do not predict severity of fetomaternal alloimmune thrombocytopenia. Transfusion, 47 (7), 1296-1305.Full text not available from this repository.
BACKGROUND - The antenatal management of fetomaternal alloimmune thrombocytopenia (FMAIT) due to HPA-1a antibodies remains controversial, and a test identifying pregnancies that do not require therapy would be of clinical value.
STUDY DESIGN AND METHODS - The statistical correlation was analyzed between clinical outcome and 1) anti-HPA-1a potency in maternal serum samples determined by a monoclonal antibody immobilization of platelet (PLT) antigen assay with an international anti-HPA-1a potency standard and 2) anti-HPA-1a biological activity measured by a monocyte chemiluminescence (CL) assay.
RESULTS - A total of 133 pregnancies with FMAIT due to anti-HPA-1a were analyzed. In 97 newly diagnosed cases, there was no difference in antibody potency or CL signal between cases with intracranial hemorrhage (ICH; n = 15), those with no ICH but a PLT count of less than 20 x 10(9) per L (n = 52), and those with a PLT count of at least 20 x 10(9) per L (n = 30). In 22 previously known pregnancies, the positive predictive value of maternal anti-HPA-1a of greater than 30 IU per mL for a PLT count of less than 20 x 10(9) per L was 90 percent, but the negative predictive value was only 66 percent. Antibody potency tended to stay stable throughout pregnancy (n = 16) and from one pregnancy to the next (n = 16).
CONCLUSION - Neither severe thrombocytopenia nor ICH in HPA-1a-alloimmunized pregnancies can be predicted with sufficient sensitivity and specificity for clinical application from maternal anti-HPA-1a potency or bioactivity.
|Additional Information:||Article first published online: 2 MAY 2007|
|Research Institute, Centre or Group:||Biomolecular Sciences Research Centre|
|Depositing User:||Jamie Young|
|Date Deposited:||03 Jun 2015 13:33|
|Last Modified:||03 Jun 2015 13:33|
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