Maternal HPA-1a antibody level and its role in predicting the severity of Fetal/Neonatal Alloimmune Thrombocytopenia: a systematic review.
alloimmune thrombocytopenia
bleeding
maternal HPA-1a antibodies
monoclonal antibody immobilization of platelet antigen
platelet
Journal
Vox sanguinis
ISSN: 1423-0410
Titre abrégé: Vox Sang
Pays: England
ID NLM: 0413606
Informations de publication
Date de publication:
Jan 2019
Jan 2019
Historique:
received:
19
04
2018
revised:
05
09
2018
accepted:
19
10
2018
pubmed:
20
12
2018
medline:
22
3
2019
entrez:
20
12
2018
Statut:
ppublish
Résumé
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. The studies included were categorized by recruitment strategies: screening of unselected pregnancies or samples analyzed from known or suspected FNAIT patients. 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. HPA-1a antibody level has the potential to predict the severity of FNAIT.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
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
METHODS
The studies included were categorized by recruitment strategies: screening of unselected pregnancies or samples analyzed from known or suspected FNAIT patients.
RESULTS
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
CONCLUSIONS
HPA-1a antibody level has the potential to predict the severity of FNAIT.
Substances chimiques
Antigens, Human Platelet
0
Biomarkers
0
ITGB3 protein, human
0
Integrin beta3
0
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
79-94Subventions
Organisme : Canadian Blood Services
Organisme : European Union Seventh Framework Program PROFNAIT project
Investigateurs
Shubha Allard
(S)
Celso Bianco
(C)
Jeannie Callum
(J)
Veerle Compernolle
(V)
Dean Fergusson
(D)
Susan Nahirniak
(S)
Katerina Pavenski
(K)
Joanne Pink
(J)
Cynthia So-Osman
(C)
Simon J Stanworth
(SJ)
Zbigniew M Szczepiorkowski
(ZM)
Erica Wood
(E)
Informations de copyright
© 2018 International Society of Blood Transfusion.