Maternal HPA-1a antibody level and its role in predicting the severity of Fetal/Neonatal Alloimmune Thrombocytopenia: a systematic review
| Autor: | Kjaer, M., Bertrand, G., Bakchoul, T., Massey, E., Baker, J.M., Lieberman, L., Tanael, S., Greinacher, A., Murphy, M.F., Arnold, D.M., Baidya, S., Bussel, J., Hume, H., Kaplan, C., Oepkes, D., Ryan, G., Savoia, H., Shehata, N., Kjeldsen-Kragh, J., Allard, S., Bianco, C., Callum, J., Compernolle, V., Fergusson, D., Fung, M., Nahirniak, S., Pavenski, K., Pink, J., So-Osman, C., Stanworth, S.J., Szczepiorkowski, Z.M., Wood, E., Int Collaboration Transfusion Med |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Antibody level 030204 cardiovascular system & hematology Monoclonal antibody 03 medical and health sciences 0302 clinical medicine Pregnancy Humans Medicine Antigens Human Platelet Prospective cohort study platelet Fetus Antibody measurement biology Platelet Count business.industry Obstetrics monoclonal antibody immobilization of platelet antigen maternal HPA-1a antibodies Infant Newborn Integrin beta3 Retrospective cohort study Hematology General Medicine medicine.disease bleeding Thrombocytopenia Neonatal Alloimmune Neonatal alloimmune thrombocytopenia biology.protein Female alloimmune thrombocytopenia Antibody business Biomarkers Maternal Serum Screening Tests 030215 immunology |
| Zdroj: | Vox Sanguinis, 114(1), 79-94. WILEY |
| Popis: | Background and Objectives: In Caucasians, fetal/neonatal alloimmune thrombocytopenia (FNAIT) is most commonly due to maternal HPA-1a antibodies. HPA-1a typing followed by screening for anti-HPA-1a antibodies in HPA-1bb women may identify first pregnancies at risk. Our goal was to review results from previous published studies to examine whether the maternal antibody level to HPA-1a could be used to identify high-risk pregnancies. Materials and Methods: The studies included were categorized by recruitment strategies: screening of unselected pregnancies or samples analyzed from known or suspected FNAIT patients. Results: Three prospective studies reported results from screening programmes, and 10 retrospective studies focused on suspected cases of FNAIT. In 8 studies samples for antibody measurement, performed by the monoclonal antibody immobilization of platelet antigen (MAIPA) assay, and samples for determining fetal/neonatal platelet count were collected simultaneously. In these 8 studies, the maternal antibody level correlated with the risk of severe thrombocytopenia. The prospective studies reported high negative predictive values (88–95%), which would allow for the use of maternal anti-HPA-1a antibody level as a predictive tool in a screening setting, in order to identify cases at low risk for FNAIT. However, due to low positive predictive values reported in prospective as well as retrospective studies (54–97%), the maternal antibody level is less suited for the final diagnosis and for guiding antenatal treatment. Conclusion: HPA-1a antibody level has the potential to predict the severity of FNAIT. (Less) |
| Databáze: | OpenAIRE |
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