HPA-1a antibody potency and bioactivity do not predict severity of fetomaternal alloimmune thrombocytopenia

Ghevaert, Cedric, Campbell, Kate, Stafford, Prachi, Metcalfe, Paul, Casbard, Angela C. ORCID: https://orcid.org/0000-0001-6241-3052, 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) , pp. 1296-1305. 10.1111/j.1537-2995.2007.01273.x

Full text not available from this repository.

Abstract

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 × 109 per L (n = 52), and those with a PLT count of at least 20 × 109 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 × 109 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.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Subjects:	R Medicine > RC Internal medicine
Publisher:	Wiley
ISSN:	0041-1132
Last Modified:	25 Oct 2022 09:45
URI:	https://orca.cardiff.ac.uk/id/eprint/59900

Citation Data

Cited 43 times in Scopus. View in Scopus. Powered By Scopus® Data

Actions (repository staff only)

Edit Item