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Re: "Cytotoxic Crossmatch"From: Mark Perloe, M.D. (mperloe@ivf.com)Sun Jun 7 10:27:44 1998
There is no data that cyto crossmatch abnormalities are best treated with prednisone. The cytotoxic crossmatch is supposed to detect "blocking antibodies" that are believed to protect the pregnancy from immunologic rejection. They may attach to and "defuse" activated NK cells or prevent their activation. That data is foggy, because the test is frequently negative in those who carry pregnancies just fine AND a marked difference in techniques to detect these antibodies. Flow cytometry methods seem to be the most reliable. Literature would suggest that LIT (white cell immunization) will result in the formation of these antibodies in up to 85% of women who are immunized. Whether the role of blocking antibodies is an independent factor, or only important as a factor associated with abnormal NK activity is in my opinion unclear. In the multicentre trial, it appeared that those with primary recurrent pregnancy loss will benefit to a significant degree by LIT. The benefit is small and less clear for those with secondary losses. At present, I would not treat the absence of blocking antibody with prednisone.
At 11:47 AM 6/5/98 -0500, you wrote:
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