Maternal alloimmunization to HLA, platelet and granulocyte‐specific antigens during pregnancy: its influence on cord blood granulocyte and platelet counts

Abstract

In order to obtain an estimate of the frequency of platelet-specific and granulocyte-specific antibodies and of the effect of such antibodies on the platelet count and granulocyte count of the newborn infant, serum from 147 women in their second or subsequent pregnancies was tested. No platelet-specific antibodies were found but 29 of the women had granulocyte-specific antibodies and the corresponding infants had granulocyte counts which were significantly lower than those of infants without antibodies. HLA antibodies were found in the sera of 57 women but were not associated with diminished platelet or granulocyte counts in the corresponding infants. Maternal granulocyte antibodies may be an underestimated contributory factor in the pathogenesis of neonatal neutropenia.

Pilot study of HLA alloimmunization after transfusion with pre‐storage leucodepleted blood products in aplastic anaemia

“…Maternal alloimmunization to HLA antigens occurs in 40% of pregnancies (Skacel et al, 1989). In a previous study, leucodepletion of blood products did not reduce the incidence of alloimmunization and platelet refractoriness in this highrisk group of patients (Sintnicolaas et al, 1995).…”

Platelets and Neutrophils from Healthy Term Neonates Exhibit Increased Levels of Immunoglobulins

“…Immune-mediated cytopenias in the newborn are predominantly the result of maternal alloimmunization to cell surface antigens that may be restricted to certain cell types or part of the HLA loci (5,6). Maternal alloimmunization to HLA antigens occurs in about 40% of pregnancies; however, alloimmunization to platelet-and neutrophil-specific antigens occurs less frequently (14,15).…”

“…The laboratory evaluation of immune-mediated cytopenias depends upon the detection and quantitation of Ig against platelets and neutrophils compared with healthy controls (2,(4)(5)(6). However, the paucity of normal values for healthy, term infants hampers the interpretation and limits the diagnostic was not a significant difference in direct platelet-associated IgM, or indirect Ig to neutrophils or platelets.…”

“…Immune-mediated thrombocytopenia and neutropenia represent a significant etiology for these cytopenias (3,4). These immune-mediated cytopenias may be characterized as alloimmune or autoimmune and result from increased amounts of IgG bound to the cell surface (direct) andlor identified in the serum (indirect) resulting in increased cell turnover (3,5,6). …”

Resistance to Recombinant Human Granulocyte Colony-Stimulating Factor in Neonatal Alloimmune Neutropenia Associated With Anti-Human Neutrophil Antigen-2a (NB1) Antibodies

“…A wide variety of antigenic targets have been identified in NAN, including the HNA-1, HNA-2, and HNA-3 antigen groups, besides NC1, SH, SAR, LAN, LEA, CN1, 18 -21 and possibly, 22 the human leukocyte antigens. 2,23,24 In the United States, however, one half of all of the cases of NAN are mediated by antibodies that bind to 1 of 3 antigens: HNA-1a (NA1), HNA-1b (NA2), or HNA-2a (NB1).…”