Transfusions of leukocyte‐rich erythrocyte concentrates: A successful treatment in selected cases of habitual abortion

Unander, A. M.; Lindholm, Annika

doi:10.1016/0020-7292(87)90189-5

Cited by 7 publications

(9 citation statements)

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“…64 It has been postulated that presence of MLR-Babs in patients with recurrent abortion is a sign of autoimmune disorder and using blood transfusion for therapy against habitual pregnancy loss in these patients has been not recommended. 108 Recently Yang et al 109 represented that MLR-Bf could be a good predictive indicator of pregnancy outcome in patients with unexplained RPL and with no history of embryonic cardiac activity after LIT. In patients with certain types of autoimmunity, for example, having antiphospholipid antibody, antinuclear antibody, and antithyroid antibody, LIT alone may not be sufficient for preventing pregnancy loss.…”

Section: Studiesmentioning

confidence: 99%

“…Higher levels of TNFα (>400 pg/mL) Gharesi-Fard et al 36 Negative for MLR-BAbs Adachi et al, 64 Unander, 108…”

Section: Criteria Related Studymentioning

confidence: 99%

“…For example, in 1994, Christiansen et al 103 claimed that immunization could not provide an overall advantage in the group of women with miscarriage; although, it may improve the outcome with respect to the number of live birth among women with primary RPL. It has been postulated that presence of MLR-Babs in patients with recurrent abortion is a sign of autoimmune disorder and using blood transfusion for therapy against habitual pregnancy loss in these patients has been not recommended 108. 104 However, it should be mentioned that the results of this review were significantly influenced by the findings of a randomized clinical trial conducted by Ober et al 105 in which lack of beneficial effect of immunotherapy on pregnancy outcome of patients with RPL was reported.…”

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confidence: 93%

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Lymphocytes immunotherapy for preserving pregnancy: Mechanisms and Challenges

Taheri

Nejabati

Latifi

et al. 2018

American J Rep Immunol

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Due to the expression of paternal antigens by the embryo, pregnancy is considered as a semi-allograft and so immunological dysregulation is considered as one of the important causes in repeated implantation failure (RIF) and recurrent pregnancy loss (RPL). It has been revealed that lymphocytes immunotherapy (LIT) could be an appropriate approach to prevent pregnancy loss in such patients. Various mechanisms have been suggested for effectiveness of LIT such as enhancing expression of anti-paternal cytotoxic antibodies (APCA), progesterone-induced blocking factor (PIBF), anti-idiotypic antibodies (Ab2), and mixed lymphocyte reaction blocking antibodies (MLR-Bf), as well as reduction in the T helper 1/T helper 2 ratio and deviation in the pattern of cytokines production. However, there are controversial results about the beneficial effect of LIT treatment in RIF and RPL patients. In the current study, we reviewed findings of LIT in RIF and RPL patients with a focus on possible mechanisms of alloimmunization in preserving pregnancy. Besides, we highlighted possible reasons for mixed results about the effectiveness of LIT and way of solving the problem. Also, we proposed potential laboratory and clinical criteria to recruit patients for LIT.

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Section: Studiesmentioning

confidence: 99%

“…Higher levels of TNFα (>400 pg/mL) Gharesi-Fard et al 36 Negative for MLR-BAbs Adachi et al, 64 Unander, 108…”

Section: Criteria Related Studymentioning

confidence: 99%

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confidence: 93%

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Lymphocytes immunotherapy for preserving pregnancy: Mechanisms and Challenges

Taheri

Nejabati

Latifi

et al. 2018

American J Rep Immunol

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“…These results have encouraged the wider use of immunopotentiation for habitual aborters, and created an intense demand for treatment. Unander et al [20] however immunize 1 ° and 2 o aborters. Each center has different indications and uses different regimens of immunization.…”

Section: Introductionmentioning

confidence: 99%

Selection of patients with habitual abortion for paternal leucocyte immunization

Carp

Toder

Gazit

et al. 1990

Arch Gynecol Obstet

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After potentiation of the immune response in habitual aborters 75-85% of subsequent pregnancies are claimed to result in healthy term infants. However, all publications to date have either been based on the authors concept of the immune processes involved or an attempt to demonstrate the efficacy of treatment either empirically or by matched trials. As immunization is coming into wider clinical use, it is necessary to determine which patients will benefit from this form of treatment. This paper presents our experience with paternal leucocyte immunization over the period 1985-1988. 207 patients were classified on a clinical basis and by immunological testing. 143 patients have been immunised, 129 pregnancies have occurred in 108 patients. The vast majority of our patients have recurrent missed abortions. Only six women habitually aborted live fetuses. Two had subsequent live births. Secondary aborters seem to do well in subsequent pregnancies, whether immunized or not. The patient most likely to benefit from immunization is the Primary missed aborter who does not possess antipaternal antibody (APCA), but is induced to produce APCA by immunization. Using these criteria, 75% success rates are observed in the subsequent pregnancy. This success rate is irrespective of HLA antigen sharing or in-vitro mixed lymphocyte reactivity.

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“…The procedure of immunization with leukocytes from third party donors as performed in the present trial (using buffycoat) and in most patients in another center using leukocyte-rich erythrocyte concentrates (22) differs from the immunization with husbands' cells in three ways. Firstly, the amount of leukocytes provided per immunization is about ten times greater than when husband's cells are used because the majority of the leukocytes are removed by the density gradient separation.…”

Section: Discussionmentioning

confidence: 98%