Lessons learnt from many years of experience using anti-D in humans for prevention of RhD immunization and haemolytic disease of the fetus and newborn.
For 40 years prophylactic anti-D has been given to D-negative women after parturition to prevent haemolytic disease of the fetus and newborn. Monoclonal or recombinant anti-D may provide alternatives to the current plasma-derived polyclonal IgG anti-D, although none of them have yet proved as effective in phase 1 clinical trials. The variation in efficacy of the antibodies may have been influenced by heterogeneity in glycosylation of anti-D produced from different cell lines. Some aspects of the conduct of the human studies, most notably the use of low doses of anti-D and target D positive red cells in vivo, may aid the design of the clinical development of other immunomodulatory drugs in order to minimize adverse effects.
Kumpel
B M
BM
Bristol Institute for Transfusion Sciences, International Blood Group Reference Laboratory, National Blood Service, NHS Blood and Transplant, Bristol, UK. belinda.kumpel@nbs.nhs.uk
D002986:Clinical Trials as Topic; D004899:Erythroblastosis, Fetal / Q000517:prevention & control*; D005260:Female; D005333:Fetus / Q000276:immunology; D006801:Humans; D007231:Infant, Newborn / Q000276:immunology*; D007518:Isoantibodies / Q000008:administration & dosage*; D011247:Pregnancy / Q000276:immunology*; D012203:Rh Isoimmunization / Q000188:drug therapy*; D012204:Rh-Hr Blood-Group System / Q000276:immunology*; D018029:Rho(D) Immune Globulin
D007518:Isoantibodies; C061961:RHO(D) antibody; D012204:Rh-Hr Blood-Group System; D018029:Rho(D) Immune Globulin