{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:33:07Z","timestamp":1788258787517,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T00:00:00Z","timestamp":1759622400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Fetal\/neonatal alloimmune thrombocytopenia (\n                      <jats:styled-content style=\"fixed-case\">FNAIT<\/jats:styled-content>\n                      ) and neonatal alloimmune neutropenia (\n                      <jats:styled-content style=\"fixed-case\">NAIN<\/jats:styled-content>\n                      ) result from maternal alloantibodies targeting fetal human platelet antigen (\n                      <jats:styled-content style=\"fixed-case\">HPA<\/jats:styled-content>\n                      ) and human neutrophil antigen (\n                      <jats:styled-content style=\"fixed-case\">HNA<\/jats:styled-content>\n                      ) antigens, respectively. However, increasing evidence supports the pathogenic role of\n                      <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\n                      class I alloantibodies in these conditions. Since the simultaneous occurrence of\n                      <jats:styled-content style=\"fixed-case\">FNAIT<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">NAIN<\/jats:styled-content>\n                      has not been systematically investigated, this study aimed to determine its prevalence, characterize the specificity and strength of associated alloantibodies, and correlate findings with neonatal cell counts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>In this cross\u2010sectional study, 10,000 umbilical cord blood samples were analyzed for platelet and neutrophil counts. Neonates with thrombocytopenia and neutropenia were selected. Genotyping for HPA, HNA, and HLA class I was performed in mother\u2010infant pairs to assess incompatibilities. Maternal sera were tested for anti\u2010HPA, anti\u2010HNA, and anti\u2010HLA antibodies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ten cases (0.1%) of concurrent cytopenias were identified. Alloantibodies were detected in four cases: one with combined anti\u2010HPA\u20105b, HNA\u20102, and HLA\u2010A2 antibodies; and three with isolated high\u2010mean fluorescence intensity (MFI) HLA antibodies (anti\u2010HLA\u2010A2, HLA\u2010A3, HLA\u2010B7). Anti\u2010HLA\u2010A2 was linked to the lowest neutrophil counts, and anti\u2010HLA\u2010B7 to severe thrombocytopenia. The estimated prevalence of simultaneous FNAIT and NAIN was 0.04% (1 in 2500 neonates).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This is the first large\u2010scale study to document the co\u2010occurrence of FNAIT and NAIN. Our findings explore the serological and molecular features of these immune syndromes and underscore the potential pathogenic role of maternal anti\u2010HLA class I antibodies, even in the absence of detectable anti\u2010HPA or anti\u2010HNA, and support including HLA testing in the diagnostic workup of neonatal cytopenias.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.18429","type":"journal-article","created":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T14:53:42Z","timestamp":1759676022000},"page":"2169-2177","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Concurrent neonatal alloimmune neutropenia and thrombocytopenia: Prevalence and antibody specificity and intensity in a large Brazilian cohort"],"prefix":"10.1111","volume":"65","author":[{"given":"Leandra C.","family":"Nogueira\u2010Silva","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Oncology, Division of Hematology and Hemotherapy Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0324-6175","authenticated-orcid":false,"given":"Jos\u00e9 O.","family":"Bordin","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Oncology, Division of Hematology and Hemotherapy Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samira A.","family":"Abbas","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Oncology, Division of Hematology and Hemotherapy Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Hospital Geral de Guarulhos  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7837-166X","authenticated-orcid":false,"given":"Larissa B.","family":"Lopes","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Oncology, Division of Hematology and Hemotherapy Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akemi K.","family":"Chiba","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Oncology, Division of Hematology and Hemotherapy Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefina A. P.","family":"Braga","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Oncology, Division of Hematology and Hemotherapy Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Department of Pediatrics Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana O.","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Oncology, Division of Hematology and Hemotherapy Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Cerqueira","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Oncology, Division of Hematology and Hemotherapy Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen N. 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