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Postnatal intervention for the treatment of FNAIT : a systematic review

Baker, Jillian M. ; Shehata, Nadine ; Bussel, James ; Murphy, Michael F. ; Greinacher, Andreas ; Bakchoul, Tamam ; Massey, Edwin ; Lieberman, Lani ; Landry, Denise and Tanael, Susano , et al. (2019) In Journal of Perinatology 39(10). p.1329-1339
Abstract


Objective: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is associated with life-threatening bleeding. This systematic review of postnatal management of FNAIT examined transfusion of human platelet antigen (HPA) selected or unselected platelets, and/or IVIg on platelet increments, hemorrhage and mortality. Study design: MEDLINE, EMBASE and Cochrane searches were conducted until 11 May 2018. Result: Of 754 neonates, 382 received platelet transfusions (51%). HPA-selected platelets resulted in higher platelet increments and longer response times than HPA-unselected platelets. However, unselected platelets generally led to sufficient platelet increments to 30 × 10 ... (More)


Objective: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is associated with life-threatening bleeding. This systematic review of postnatal management of FNAIT examined transfusion of human platelet antigen (HPA) selected or unselected platelets, and/or IVIg on platelet increments, hemorrhage and mortality. Study design: MEDLINE, EMBASE and Cochrane searches were conducted until 11 May 2018. Result: Of 754 neonates, 382 received platelet transfusions (51%). HPA-selected platelets resulted in higher platelet increments and longer response times than HPA-unselected platelets. However, unselected platelets generally led to sufficient platelet increments to 30 × 10
9
/L, a level above which intracranial hemorrhage or other life-threatening bleeding rarely occurred. Platelet increments were not improved with the addition of IVIg to platelet transfusion. Conclusion: Overall, HPA-selected platelet transfusions were more effective than HPA-unselected platelets but unselected platelets were often effective enough to achieve clinical goals. Available studies do not clearly demonstrate a benefit for addition of IVIg to platelet transfusion.

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publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Perinatology
volume
39
issue
10
pages
1329 - 1339
publisher
Nature Publishing Group
external identifiers
  • pmid:30971767
  • scopus:85064195873
ISSN
0743-8346
DOI
10.1038/s41372-019-0360-7
language
English
LU publication?
yes
id
e87de436-76ce-4472-aa2b-21294bdc4ce4
date added to LUP
2019-05-09 14:09:27
date last changed
2020-10-27 03:27:42
@article{e87de436-76ce-4472-aa2b-21294bdc4ce4,
  abstract     = {<p><br>
                                                         Objective: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is associated with life-threatening bleeding. This systematic review of postnatal management of FNAIT examined transfusion of human platelet antigen (HPA) selected or unselected platelets, and/or IVIg on platelet increments, hemorrhage and mortality. Study design: MEDLINE, EMBASE and Cochrane searches were conducted until 11 May 2018. Result: Of 754 neonates, 382 received platelet transfusions (51%). HPA-selected platelets resulted in higher platelet increments and longer response times than HPA-unselected platelets. However, unselected platelets generally led to sufficient platelet increments to 30 × 10                             <br>
                            <sup>9</sup><br>
                                                         /L, a level above which intracranial hemorrhage or other life-threatening bleeding rarely occurred. Platelet increments were not improved with the addition of IVIg to platelet transfusion. Conclusion: Overall, HPA-selected platelet transfusions were more effective than HPA-unselected platelets but unselected platelets were often effective enough to achieve clinical goals. Available studies do not clearly demonstrate a benefit for addition of IVIg to platelet transfusion.                         <br>
                        </p>},
  author       = {Baker, Jillian M. and Shehata, Nadine and Bussel, James and Murphy, Michael F. and Greinacher, Andreas and Bakchoul, Tamam and Massey, Edwin and Lieberman, Lani and Landry, Denise and Tanael, Susano and Arnold, Donald M. and Baidya, Shoma and Bertrand, Gerald and Kjaer, Mette and Kaplan, Cécile and Kjeldsen-Kragh, Jens and Oepkes, Dick and Savoia, Helen and Ryan, Greg and Hume, Heather},
  issn         = {0743-8346},
  language     = {eng},
  number       = {10},
  pages        = {1329--1339},
  publisher    = {Nature Publishing Group},
  series       = {Journal of Perinatology},
  title        = {Postnatal intervention for the treatment of FNAIT : a systematic review},
  url          = {http://dx.doi.org/10.1038/s41372-019-0360-7},
  doi          = {10.1038/s41372-019-0360-7},
  volume       = {39},
  year         = {2019},
}