Improved maternal and fetal outcomes in pregnancies complicated by primary immune thrombocytopenia (ITP), which have an increased risk for fetal and neonatal alloimmune thrombocytopenia (FNAIT), can be enhanced by continued research and therapeutic advancements, according to a review published recently in the journal Cureus.
In addition, relevant data will be presented at the American Society of Human Genetics (ASHG) 2024 Annual Meeting, scheduled to be held in Denver, CO, on Nov. 5—9.
ITP is associated with considerable risks for both the mother and the child. Among individuals with severe ITP, reported platelet counts are typically below 20,000 per microliter of blood. Because such situations can be associated with severe hemorrhage, careful monitoring and proactive management of patients are recommended.
In situations in which severe ITP occurs in a fetus, FNAIT may develop. The occurrence of FNAIT is best described as a situation in which maternal antibodies traverse the placenta and subsequently target fetal platelets. In fact, this event can lead to severe ITP and potentially life-threatening complications, including intracranial hemorrhage in a neonate.
Results from a study conducted by Rallybio in partnership with HealthLumen will be presented at ASHG 2024. The study is intended to quantify the percentage of women across a broad range of populations who are at risk for experiencing an FNAIT-impacted pregnancy
Read more about FNAIT prognosis
Rallybio is currently in Phase 2 of a trial evaluating the anti–human platelet antigen (HPA)-1a (HPA-1a) antibody RLYB212 that has been developed for the prevention of FNAIT. Currently, there is no therapy available for the treatment and prevention of FNAIT.
In order to decrease the risks linked to FNAIT and guarantee optimal patient outcomes, effective management of individuals with the disorder is critical. According to findings from the current review, multidisciplinary care, along with vigilant monitoring and treatment adjustments, is warranted according to the severity of thrombocytopenia and the stage of a woman’s pregnancy.
In FNAIT, “the anti–HPA-1a antibodies that develop in the mother can lead can cross the placenta and destroy platelets in the fetus. The destruction of platelets in the fetus can result in severely low platelet counts, or thrombocytopenia, and potentially lead to devastating consequences.”
The current review of ITP during pregnancy was intended to tackle the following:
- Pathophysiology of ITP
- Diagnosis of ITP in pregnancy
- Strategies used for managing ITP in pregnancy
- Special considerations in pregnancy, including monitoring, follow-up, maternal/fetal risks, and labor/delivery planning
- Future directions and research, such as innovative therapies/treatments and the use of personalized medicine in the management of ITP
“[N]avigating primary ITP during pregnancy requires a nuanced and multidisciplinary approach to ensure the safety and well-being of both mother and fetus,” the authors highlighted. “Continued research and advancements in therapeutic approaches are essential to further refine management strategies and improve the quality of care for pregnant women with ITP.”
