In vitro culture of colony forming unit‐megakaryocyte (CFU‐MK) in fetal alloimmune thrombocytopenia

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Abstract
Summary . Perinatal alloimmune thrombocytopenia (PAITP) causes intracranial haemorrhage in the fetus and neonate. However, the severity of the thromobocytopenia correlates poorly with maternal anti-platelet antibody titres. To test the hypothesis that reduced platelet production contributes to fetal thrombocytopenia in PAITP, maternal sera from three HPA-la-negative mothers whose pregnancies were complicated by anti-HPA-la (two severe cases, one mild case) were added to colony forming unit-megakaryocyte (CFU-MK) cultures from HPA-la positive and negative individuals. Sera from the two severely affected pregnancies containing anti-HPA-la caused 66–100% inhibition of HPA-la-positive fetal and neonatal CFU-MK, whereas CFU-MK from two HPA-la-negative mothers were not inhibited by the anti-HPA-la-containing sera. Maternal serum from the case of mild PAITP caused only mild inhibition of HPA-la-positive cord and adult CFU-MK and did not inhibit HPA-la-positive fetal CFU-MK. Taken together, these findings suggest that reduced megakaryocyte production contributes to fetal thrombocytopenia due to maternal anti-HPA-la antibodies and also that the degree of CFU-MK inhibition correlates with severity of fetal thrombocytopenia.