Anti-IIb3 immunization in Glanzmann thrombasthenia: review of literature and treatment recommendations

Glanzmann thrombasthenia (GT)is caused by inherited defects of the (IIb3) platelet glycoprotein. This bleeding disorder can be treated with platelet transfusion therapy, but some patients will be immunized and begin to form anti-human leucocyte antigen (HLA) and/or anti-(IIb3) antibodies. These antibodies can bind and interfere with the function of the transfused platelets, rendering treatment ineffective. However, platelet transfusion refractoriness attributable to HLA antibodies may be managed by the selection of compatible donors, although they are not always readily available, particularly in an emergency. Thus, anti-(IIb3) antibodies represent one of the most severe complications in GT. Both genetic and environmental factors may contribute to the risk of anti-(IIb3) development, but the underlying pathogenic mechanisms are still unknown. Thisreviewwill summarize the current knowledge of the risk factors for development of anti-(IIb3) antibodies in patients with GT and discuss how these findings may influence the clinical management of patients.