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Inhibitors in children during secondary prophylaxis for hemophilia in a developing country
Abstract number: PP-MO-160
Linares1 A., Aristizabal1 M., Sarmiento1 I., Castaņo1 S., Cortes1 M.
11Pediatric Hematology Oncology, Hospital La Misericordia-Universidad Nacional De Colombia, Bogota, Colombia
How-to-cite Linares A, Aristizabal M, Sarmiento I, Castaņo S, Cortes M. Inhibitors in children during secondary prophylaxis for hemophilia in a developing country. Journal of Thrombosis and Haemostasis 2009; Volume 7, Supplement 2: Abstract PP-MO-160
Background: Prophylaxis is considered standard of care in patients with Severe Hemophilia (SH). Evidence worldwide has demonstrated a reduction in the frequency of bleeding episodes, arthropathy and hospitalizations. Physicians have to deal with two major challenges: the probability of developing inhibitors as a complication of therapy and the high cost of prophylaxis in developing countries. The aim of this study is to evaluate the development of inhibitors in a group of pediatric patients during secondary prophylaxis.
Methods: We conducted a pilot retrospective study in 15 boys who had SH. In all patients prophylaxis was started as secondary .The number of target joints, any switch in the type of Factor VIII (F VIII) concentrate and the inhibitor titer were followed at least for one year. Patients were tested for inhibitor titers at least twice a year.
Results: the inhibitor titer was meassured before starting prophylaxis and was 0,16 range IC 95% 0.1-0.45 Bethesda Units/ml (BU). The majority of patients received the same type of F VIII through all the treatment and only two were switched to another type of product.
Table: Demographics of patients on prophylaxis
| Hemophilia A:B | 13:2 |
|---|
| Severity of hemophilia | Moderate: 1, Severe:14 |
| Mean age (years) | 7.8 years (IC 95% 4.7 - 10.8 years) |
| Number of target joints | 2 (range 1 - 6) |
| Inhibitor titer during prophylaxis | 0.003 BU (0 - 0.1) |
| Type of F VIII | Recombinant : 3, Plasma derived: 12 |
| Mean time on prophylaxis (months) | 34.3 months (range 6 - 72) |
| Mean dose on prophylaxis (u/kilo) | 22 (range 15 - 40) |
Conclusions: In this cohort of patients receiving prophylaxis with factor VIII, there was no development of inhibitors. The majority of the patients were treated with plasma derived human F VIII containing VWF. In developing countries, prophylaxis could be tried with F VIII containing VWF in order to reduce costs. Follow-up is crucial to assess the protective effect of prophylaxis in Hispanics.
Disclosure of interest: none declared.
To cite this abstract use the following format:
Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number
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