Congress of the International Society on Thrombosis and Haemostasis

Differential effect of prophylactic or on demand treatment regimes in hemophilia A patients on TAFI activation

Abstract number: PP-MO-533

Mikovic¹ D., Holmström² M., Woodhams³ B.J., Antovic² J.

¹¹Hemostasis Department and Hemophilia Center, Blood Transfusion Institute, Belgrade, Serbia ²²Hematology and Clinical Chemisty, Karolinska University Hospital, Stockholm, Sweden ³³Research and Development, Diagnostica Stago, Gennevilliers, France

How-to-cite Mikovic D, Holmström M, Woodhams BJ, Antovic J. Differential effect of prophylactic or on demand treatment regimes in hemophilia A patients on TAFI activation. Journal of Thrombosis and Haemostasis 2009; Volume 7, Supplement 2: Abstract PP-MO-533

To better understand the effect of treatment of hemophilia A patients on TAFI levels 2 groups of patients were evaluated: one on a prophylactic regime (n = 17 recombinant FVIII 1000–3000 IU, 1–3 times weekly – in Sweden), the second treated on demand (n = 35 highly purified plasma derived FVIII 1000–2000 I.U.- in Serbia). Samples were collected pre and 30 min post treatment and as controls from 30 normal healthy in both centres. The level of TAFI (proenzyme) and the TAFIa/i (corresponds to the total amount of the enzyme that has been activated) was determined in all samples (Asserachrom TAFI and TAFa/i, Diagnostica Stago, France). No significant difference in the Swedish or Serbian control values for TAFI (7.83 and 6.61 μg/mL respectively) or TAFIa/i (10.48 and 10.63 ng/mL respectively) was observed. Treatment had no effect on the pre and post TAFI or TAFIa/i levels but TAFI levels were significantly higher in both groups than controls (11.74 and 10.58 μg/mL). In the prophylaxis group pre and post TAFIa/i level were significantly lower (4.77 and 4.03 ng/mL respectively) in patients than in controls. This change was not observed in the treatment group where the TAFIa/i level was higher than control values pre and post treatment (12.72 ng/mL and 14.65 ng/mL respectively). Raised levels of TAFI were found in hemophilia patients and treatment had no effect on these levels. Patients on prophylaxis had lower levels of TAFI activation while those treated on demand had higher levels of TAFI activation. The mechanism for this treatment effect needs further evaluation to explain if it is possible that mechanisms other than thrombin generation can modulate TAFI generation.

Disclosure of interest: B Woodhams – full time employee of Diagnostica Stago.

To cite this abstract use the following format:

Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number

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Date:	Unpresented
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Session name:	ISTH2009
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