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Blood, 1 August 2007, Vol. 110, No. 3, pp. 833-839. Prepublished online as a Blood First Edition Paper on April 11, 2007; DOI 10.1182/blood-2006-08-040121. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2006-08-040121v1 110/3/833    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Kjeldsen-Kragh, J. Articles by Husebekk, A. Search for Related Content PubMed PubMed Citation Articles by Kjeldsen-Kragh, J. Articles by Husebekk, A. Related Collections Hemostasis, Thrombosis, and Vascular Biology Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS A screening and intervention program aimed to reduce mortality and serious morbidity associated with severe neonatal alloimmune thrombocytopenia Jens Kjeldsen-Kragh1,4, Mette Kjær Killie5,8, Geir Tomter1, Elzbieta Golebiowska1, Ingrid Randen1,4, Reidun Hauge1, Berit Aune6,9, Pål Øian6,9, Lauritz B. Dahl7,9, Jouko Pirhonen2,4, Rolf Lindeman3,4, Henrik Husby10, Guttorm Haugen10,12, Morten Grønn11, Bjørn Skogen5,8, and Anne Husebekk5,8 Departments of1 Immunology and Transfusion Medicine 2 Obstetrics and Gynecology, and 3 Pediatrics, Ullevål University Hospital, Oslo; 4 Faculty Division Ullevål University Hospital, University of Oslo, Oslo; Departments of5 Immunology and Transfusion Medicine 6 Obstetrics and Gynecology, and 7 Pediatrics, University Hospital of North Norway, Tromsø; Institutes of 8 Medical Biology and 9 Clinical Medicine, University of Tromsø, Tromsø; Departments of10 Obstetrics and Gynecology and 11 Pediatrics, Rikshospitalet-Radiumhospitalet Medical Center, Oslo; 12 Faculty Division Rikshospitalet, University of Oslo, Oslo, Norway The study's objective was to identify HPA 1a–negative women and to offer them an intervention program aimed to reduce morbidity and mortality of neonatal alloimmune thrombocytopenia (NAIT). HPA 1 typing was performed in 100 448 pregnant women. The HPA 1a–negative women were screened for anti–HPA 1a. In immunized women, delivery was performed by Cesarean section 2 to 4 weeks prior to term, with platelets from HPA 1a–negative donors reserved for immediate transfusion if petechiae were present and/or if platelet count was less than 35 x 109/L. Of the women screened, 2.1% were HPA 1a negative, and anti–HPA 1a was detected in 10.6% of these. One hundred seventy pregnancies were managed according to the intervention program, resulting in 161 HPA 1a–positive children. Of these, 55 had severe thrombocytopenia (< 50 x 109/L), including 2 with intracranial hemorrhage (ICH). One woman with a twin pregnancy missed the follow-up and had one stillborn and one severely thrombocytopenic live child. In 15 previous prospective studies (136 814 women) there were 51 cases of severe NAIT (3 intrauterine deaths and 7 with ICH). Acknowledging the limitation of comparing with historic controls, implementation of our screening and intervention program seemed to reduce the number of cases of severe NAIT-related complications from 10 of 51 to 3 of 57. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: M. T. Ahlen, A. Husebekk, M. K. Killie, B. Skogen, and T. B. Stuge T-cell responses associated with neonatal alloimmune thrombocytopenia: isolation of HPA-1a-specific, HLA-DRB3*0101-restricted CD4+ T cells Blood, April 16, 2009; 113(16): 3838 - 3844. [Abstract] [Full Text] [PDF] J. Kjeldsen-Kragh, M. Kim, M. K. Killie, A. Husebekk, J. Freedman, and J. W. Semple In HPA 1a-immunized women the decrease in anti-HPA 1a antibody level during pregnancy is not associated with anti-idiotypic antibodies Haematologica, March 1, 2009; 94(3): 441 - 443. [Full Text] [PDF] C. Kaplan Neonatal alloimmune thrombocytopenia Haematologica, June 1, 2008; 93(6): 805 - 807. [Full Text] [PDF] M. K. Killie, A. Husebekk, J. Kjeldsen-Kragh, and B. Skogen A prospective study of maternal anti-HPA 1a antibody level as a potential predictor of alloimmune thrombocytopenia in the newborn Haematologica, June 1, 2008; 93(6): 870 - 877. [Abstract] [Full Text] [PDF]

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