Clinical value of an antibody-dependent cell-mediated cytotoxicity assay in the management of Rh D alloimmunization.
OBJECTIVE
The aim of this study was to evaluate the clinical value of an antibody-dependent cell-mediated cytotoxicity assay relative to the indirect antiglobulin test titer in the management of Rh D-alloimmunized pregnancies.


METHODS
Data from 172 Rh D-alloimmunized pregnancies were analyzed retrospectively. The accuracies of the highest antibody titer and of the highest antibody-dependent cell-mediated cytotoxicity assay result during pregnancy to predict fetal and neonatal Rh disease, defined as the need for intrauterine (n = 30) or neonatal (n = 37) blood transfusion, respectively, were assessed.


RESULTS
At different cutoff levels with equal sensitivities the antibody-dependent cell-mediated cytotoxicity assay consistently showed a higher specificity than the antibody titer for the prediction of fetal disease. No difference was found between the receiver operating characteristic curves of the 2 tests for the prediction of neonatal disease.


CONCLUSIONS
Selection of patients for referral and invasive testing for Rh D alloimmunization may be improved with the use of an antibody-dependent cell-mediated cytotoxicity assay.
Oepkes
D
D
Division of Fetal Diagnosis and Treatment, Department of Obstetrics, Leiden University Medical Center, The Netherlands.
van Kamp
I L
IL
Simon
M J
MJ
Mesman
J
J
Overbeeke
M A
MA
Kanhai
H H
HH
D000920:Antibody-Dependent Cell Cytotoxicity / Q000276:immunology*; D003298:Coombs Test; D003601:Cytotoxicity Tests, Immunologic / Q000379:methods; D005260:Female; D005312:Fetal Blood; D006400:Hematocrit; D006801:Humans; D007231:Infant, Newborn; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D012372:ROC Curve; D012189:Retrospective Studies; D012203:Rh Isoimmunization / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D012204:Rh-Hr Blood-Group System / Q000097:blood / Q000276:immunology; D018029:Rho(D) Immune Globulin / Q000276:immunology; D018709:Statistics, Nonparametric
D012204:Rh-Hr Blood-Group System; D018029:Rho(D) Immune Globulin