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2022 AABB Annual Meeting

AM22-SN05-E - AM22-SN05-E: (On-Demand) New Prospects for Treatment and Prophylaxis of Fetal and Neonatal Alloimmune Thrombocytopenia. (Enduring)


Oct 4, 2022 12:00pm ‐ Oct 4, 2022 1:00pm



Credits: None available.

Description

Pregnant women with IgG antibodies against paternally-inherited antigens on fetal platelets are at risk of having their pregnancy complicated with fetal and neonatal alloimmune thrombocytopenia (FNAIT). IgG antibodies can traverse the placenta and cause fetal thrombocytopenia and severe bleeding. Thus, FNAIT can be considered as the platelet counterpart of hemolytic disease of the fetus and newborn (HDFN). For around 3 decades, it has been common practice to treat immunized pregnant women with high-dose IVIg. Recent data will be presented that question the necessity of treating all immunized women with IVIg. A new hyperimmune anti-HPA-1a IgG has been developed with the aim of preventing HPA-1a immunization and FNAIT in HPA-1a negative women carrying an HPA-1a positive fetus. Results of a phase 1/2 clinical trial will be presented. A monoclonal antibody against the neonatal Fc receptor (FcRn) has been developed and is currently in clinical trial in women immunized against paternally-inherited antigens on fetal red blood cells. The possibility of extending this treatment modality to FNAIT will be discussed.

Learning Objectives:
  • identify immunized women who may not need IVIg treatment
  • explain why the presence of antibodies against fetal platelets does not necessarily leads to fetal thrombocytopenia and bleeding
  • explain how monoclonal antibodies against the fetal neonatal Fc receptor may protect the fetus from maternal alloantibodies
  • predict potential adverse effects associated with treatment with monoclonal antibodies against the fetal neonatal Fc receptor
  • interpret the results of the phase 1/2 trial of a hyperimmune anti-HPA-1a IgG

Speaker(s):

  • Gregor Bein, Clinical Immunology, Transfusion Medicine and Hemostasis, Justus Liebig University
  • Christof Geisen, MD, Institute of Transfusion Medicine and Immunohematology

Moderator(s):

Disclosures

  • Jens Kjeldsen-Kragh, MD, PhD : Rallybio: Consultant Glycorex Transplantation AB: Consultant ROS Therapeutics ApS: Consultant
  • Gregor Bein : Janssen pharmaceuticals: Consultant Janssen pharmaceuticals: Principle investigator (Nipocalimab; hemolytic disease of the fetus and newborn) Janssen pharmaceuticals: Principle investigator (Nipocalimab; hemolytic disease of the fetus and newborn)
  • Christof Geisen, MD : Rallybio: Grant/Research Support (Secondary Investigators need not disclose)

Credits

Credits: None available.

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