Fetal and Neonatal Thrombopoietin Levels in Alloimmune Thrombocytopenia

Longitudinal thrombopoietin plasma concentrations in fetuses with alloimmune thrombocytopenia treated with intrauterine PLT transfusions

“…‐26 It is an inherent problem to gain a considerable high number of normal fetal blood samples for determining reference values. Previously, fetal TPO concentrations were compared with those measured in cord blood taken at birth in preterm and term neonates or adults 17,20 , 24,25 . In this study, fetal TPO plasma concentrations are described in fetuses with normal hematopoiesis, where perinatal effects on TPO concentrations can be excluded, as mentioned by others 27 .…”

“…In a previous study, we found TPO serum concentrations above the 95 percent CI of the normal value in 4 of 12 cord blood samples taken either after intrauterine PLT transfusion before delivery or in nontransfused neonates with FMAIT 19 . Recently, Porcelijn and colleagues 20 found no differences in TPO concentrations between treated (IVIGs, corticosteroids administered to the mother, and/or intrauterine PLT transfusions) or untreated fetuses with FMAIT versus healthy neonates or nonthrombocytopenic fetuses with HDN. However, a longitudinal analysis is not provided in this study, and elevated TPO concentrations in single blood samples could not be explained 20 .…”

“…Data on normal fetal TPO concentrations are limited and summarized in Table 2 20,24 . ‐26 It is an inherent problem to gain a considerable high number of normal fetal blood samples for determining reference values.…”

“…Recently, Porcelijn and colleagues 20 found no differences in TPO concentrations between treated (IVIGs, corticosteroids administered to the mother, and/or intrauterine PLT transfusions) or untreated fetuses with FMAIT versus healthy neonates or nonthrombocytopenic fetuses with HDN. However, a longitudinal analysis is not provided in this study, and elevated TPO concentrations in single blood samples could not be explained 20 . The heterogeneity in the origin of the data and the variations in TPO concentrations indicate that a longitudinal analysis of TPO concentrations in FMAIT is needed to determine their diagnostic value.…”

Megakaryocyte Growth and Development Factor Is a Potent Growth Factor for Primitive Hematopoietic Progenitors in the Human Fetus

“…MGDF mRNA has also been detected in the fetal and adult bone marrow as well as in organs such as kidney and spleen. The levels of MGDF in plasma are higher in the fetus and neonate than in the adult (17,19,20). The presence of MGDF in fetal hematopoietic tissues, such as the liver and bone marrow, indicates that this cytokine is a likely physiologic regulator of fetal hematopoiesis.…”