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Two global haemostatic assays as additional tools to monitor treatment in cases of haemophilia A

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
DOI: https://doi.org/10.1160/TH11-11-0811
Issue: 2012: 108/1 (July) pp. 1-200
Pages: 21-31

Two global haemostatic assays as additional tools to monitor treatment in cases of haemophilia A

J. P. Antovic (1), D. Mikovic (2), I. Elezovic (3), M. Holmström (4), M. Wilkens (5), P. Elfvinge (4), N. Mahmoud Hourani Soutari (1), A. Antovic (6)

(1) Coagulation Research, Institute for Molecular Medicine and Surgery, Karolinska Institutet & Department of Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden; (2) Haemostasis Department and Haemophilia Centre, Blood Transfusion Institute of Serbia, Belgrade, Serbia; (3) Clinic of Haematology, Clinical Centre of Serbia & Faculty of Medicine, University of Belgrade, Serbia; (4) Coagulation Unit, Haematology Centre, Karolinska University Hospital, Stockholm, Sweden; (5) Siemens Healthcare Diagnostics Products GmbH, Marburg, Germany; (6) Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden

Keywords

haemophilia A, prophylactic treatment, factor VIII (FVIII), endogenous thrombin potential (ETP), overall haemostatic potential (OHP), on-demand treatment

Summary

Haemophilia A patients with similar levels of factor VIII (FVIII) may have different bleeding phenotypes and responses to treatment with FVIII concentrate. Therefore, a test which determines overall haemostasis may be appropriate for treatment monitoring in some patients. We studied two global haemostatic methods:endogenous thrombin potential (ETP) and overall haemostatic potential(OHP) before and after injection of FVIII concentrate in patients with haemophilia A treated prophylactically and on-demand. A significant correlation between FVIII and both ETP and OHP was observed, while ETP and OHP differed between patients with severe and mild clinical phenotypes. Both ETP and OHP differed significantly between severe, moderate and mild haemophilia A and controls. ETP and OHP increased after intravenous injection of FVIII concentrate in both groups of patients, but in spite of higher pre-treatment values of both ETP and OHP in patients treated prophylactically, and much higher post-treatment FVIII levels in comparison with the values in patients treated on-demand, no difference after treatment was observed for either ETP or OHP. ETP and OHP may be additional alternatives for monitoring (and even for individual tailoring) treatment in patients with haemophilia A.

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