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Camelo RM, Caram-Deelder C, Duarte BP, de Moura MCB, Costa NCDM, Costa IM, Vanderlei AM, Guimarães TMR, Gouw S, Rezende SM, van der Bom J. Cardiovascular Risk Scores among Asymptomatic Adults with Haemophilia. Arq Bras Cardiol 2023; 120:e20230004. [PMID: 37729292 PMCID: PMC10519352 DOI: 10.36660/abc.20230004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/12/2023] [Accepted: 07/17/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND The mortality rate of Brazilian people with haemophilia (PwH) is decreasing, but the relative incidence of deaths associated with cardiovascular disease (CVD) is increasing. OBJECTIVES We aimed to describe the CVD risk score of PwH according to Pooled Cohort Equations Risk (PCER) Calculator tool and its treatment recommendations. We also compared the PCER estimates with the respective Framingham Risk Score (FRS). METHODS This cross-sectional study included male PwH ≥ 40 years treated at the Comprehensive Haemophilia Treatment Centre of Pernambuco (Recife/Brazil). PwH with a previous CVD event or a low-density lipid cholesterol ≥ 5.0 mmol/L were excluded. Interviews, medical file reviews, and blood tests were performed. The PCER tool was used to estimate the CVD risk and compare it with the respective FRS. A p-value < 0.05 was accepted as statistically significant. RESULTS Thirty PwH were included. Median age was 51.5 [interquartile range-IQR; 46.0-59.5] years. The prevalence of obesity, systemic arterial hypertension, diabetes mellitus, hypertriglyceridaemia, hypercholesterolaemia, and hypoHDLaemia were 20%, 67%, 24%, 14%, 47%, and 23%, respectively. The median PCER score was 6.9% [IQR; 3.1-13.2], with 50% having a high risk (PCER ≥ 7.5%). Statin use was suggested for 54% of PwH. Blood pressure was poorly controlled in 47% of PwH. The agreement between PCER and FRS was 80% (κ = 0.60; p = 0.001). CONCLUSIONS Half of the male people with haemophilia aged 40 years or older had a 10-year high risk of developing CVD with strong recommendations to improve control of dyslipidaemia and blood pressure.
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Affiliation(s)
- Ricardo Mesquita Camelo
- Faculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasilFaculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG – Brasil
- HEMOPERecifePEBrasilFundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, PE – Brasil
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenPaíses BaixosDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden – Países Baixos
| | - Camila Caram-Deelder
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenPaíses BaixosDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden – Países Baixos
- SanquinLUMCLeidenPaíses BaixosJon J van Rood Center for Clinical Transfusion Research, Sanquin/LUMC, Leiden – Países Baixos
| | - Bruna Pontes Duarte
- HEMOPERecifePEBrasilFundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, PE – Brasil
| | | | | | - Iris Maciel Costa
- HEMOPERecifePEBrasilFundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, PE – Brasil
| | - Ana Maria Vanderlei
- HEMOPERecifePEBrasilFundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, PE – Brasil
| | - Tania Maria Rocha Guimarães
- HEMOPERecifePEBrasilFundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, PE – Brasil
- Faculdade de Enfermagem Nossa Senhora das GraçasUniversidade de PernambucoRecifePEBrasilFaculdade de Enfermagem Nossa Senhora das Graças, Universidade de Pernambuco, Recife, PE – Brasil
| | - Samantha Gouw
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenPaíses BaixosDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden – Países Baixos
- Department of Pediatric HematologyEmma Children’s HospitalUniversity of AmsterdamAmsterdãPaíses BaixosDepartment of Pediatric Hematology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam,Amsterdã – Países Baixos
| | - Suely Meireles Rezende
- Faculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasilFaculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG – Brasil
| | - Johanna van der Bom
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenPaíses BaixosDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden – Países Baixos
- SanquinLUMCLeidenPaíses BaixosJon J van Rood Center for Clinical Transfusion Research, Sanquin/LUMC, Leiden – Países Baixos
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Camelo RM, Dias MM, Caram-Deelder C, Gouw S, de Magalhães LP, Zuccherato LW, Jardim LL, de Oliveira AG, de Albuquerque Ribeiro R, Franco VKB, do Rosário Ferraz Roberti M, de Araújo Callado FMR, Etto LY, de Cerqueira MAF, Cerqueira MH, Lorenzato CS, de Souza IS, Serafim ÉSS, Garcia AA, Anegawa TH, Neves DCF, Tan DM, van der Bom J, Rezende SM. Time between inhibitor detection and start of immune tolerance induction: Association with outcome in the BrazIT study. J Thromb Haemost 2022; 20:2526-2537. [PMID: 36102352 DOI: 10.1111/jth.15878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/26/2022] [Accepted: 09/12/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Immune tolerance induction (ITI) is the treatment of choice for eradication of anti-factor VIII (FVIII) neutralizing alloantibodies (inhibitors) in people with inherited hemophilia A and high-responding inhibitor (PwHA-HRi). The association between ITI outcome and time elapsed between inhibitor detection and start of ITI (∆tinhi-ITI ) is debatable. OBJECTIVE The aim of this study was to evaluate this association among a large cohort of severe PwHA-HRi. METHODS Severe (factor VIII activity level <1%) PwHA-HRi on ITI (n = 142) were enrolled in 15 hemophilia treatment centers. PwHA-HRi were treated according to the Brazilian ITI Protocol. ITI outcomes were defined as success (i.e., recovered responsiveness to exogenous FVIII) and failure (i.e., no responsiveness to exogenous FVIII and requirement of bypassing agents to control bleeding). RESULTS Median ages at inhibitor detection and at ITI start were 3.2 years (interquartile range [IQR], 1.6-8.1) and 6.9 years [IQR, 2.6-20.1), respectively. PwHA-HRi were stratified according to ∆tinhi-ITI quartiles: first (0.0-0.6 year), second (>0.6-1.7 year), third (>1.7-9.2 years), and fourth quartile (>9.2-24.5 years). The overall success rate was 65.5% (93/142), with no difference among first, second, third, and fourth quartiles (62.9%, 69.4%, 58.3%, and 71.4%, respectively) even after adjusting the analyses for potential confounders. CONCLUSION In conclusion, delayed ITI start is not associated with failure of ITI in PwHA-HRi. Therefore, ITI should be offered for these patients, regardless of the time elapsed between the detection of inhibitor and the ITI start.
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Affiliation(s)
- Ricardo Mesquita Camelo
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Maíse Moreira Dias
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Camila Caram-Deelder
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Center of Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
| | - Samantha Gouw
- Amsterdam UMC, University of Amsterdam, Department of Pediatric Hematology, Amsterdam, the Netherlands
| | | | | | - Letícia Lemos Jardim
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Rosângela de Albuquerque Ribeiro
- Centro de Hematologia e Hemoterapia do Ceará (HEMOCE), Fortaleza, Brazil
- Hospital Universitário Walter Cantídeo, Universidade Federal do Ceará, Fortaleza, Brazil
| | | | | | | | - Leina Yukari Etto
- Hemocentro da Paraíba (HEMOÍBA), João Pessoa, Brazil
- Department of Internal Medicine, Center of Medical Sciences, Universidade Federal da Paraíba, João Pessoa, Brazil
| | | | | | | | - Ieda Solange de Souza
- Department of Clinical Haematology, Centro de Hematologia e Hemoterapia do Pará (HEMOPA), Belém, Brazil
- Universitary Hospital João de Barros Barreto, Universidade Federal do Pará, Belém, Brazil
| | | | - Andrea Aparecida Garcia
- Centro de Sangue de São José do Rio Preto, São José do Rio Preto, Brazil
- Fundação Faculdade Regional de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil
| | - Tânia Hissa Anegawa
- Centro de Hematologia Regional de Londrina (HEMEPAR Londrina), Londrina, Brazil
- Faculty of Medicine, Universidade Estadual de Londrina, Londrina, Brazil
| | - Daniele Campos Fontes Neves
- Fundação Hemocentro de Rondônia (FHEMERON), Porto Velho, Brazil
- Department of Medicine, Universidade de Rondônia, Porto Velho, Brazil
| | - Doralice Marvulle Tan
- Department of Paediatric Onco-haematology, Faculdade de Medicina de Marília, Marília, Brazil
| | - Johanna van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
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Jardim LL, Santana MP, Chaves DG, van der Bom J, Rezende SM. Risk factors for antibody formation in children with hemophilia: methodological aspects and clinical characteristics of the HEMFIL cohort study. Blood Coagul Fibrinolysis 2021; 32:443-450. [PMID: 34127617 DOI: 10.1097/mbc.0000000000001057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Up to 35% of patients with hemophilia A and 5% with hemophilia B develop neutralizing antibodies which can inhibit the therapeutic activity of factor replacement (inhibitors). Despite the clinical relevance of antifactor VIII and IX neutralizing antibodies, there is still a major gap on the knowledge of risk factors for their development. Furthermore, most of the studies on risk factors for inhibitor development come from Caucasian and Afro-American populations. The HEMFIL is a Brazilian prospective cohort study of previously untreated children with hemophilia, which primary aim is to identify new risk factors related to inhibitor development. This manuscript aims at describing the study design and its methodology. After the diagnosis, children are followed up to 75 exposure days or to inhibitor development. Standardized forms and blood samples are collected to describe clinical characteristics and to perform the measurement of immunological and genetic biomarkers at three time points; Inclusion time (T0), at inhibitor development or at 75 exposure days without inhibitors (T1) and after immune tolerance induction for patients in whom it is indicated and performed (T2). Currently, 120 children have been included, of whom, 95 have completed the follow-up. For severe/moderately severe hemophilia A, the cumulative incidence of inhibitors at 75 exposure days was 35% (95% confidence interval, 26-46%). The inclusion of additional patients and a longer follow-up will allow the analysis of risk factors for inhibitor development.
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Affiliation(s)
- Letícia L Jardim
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Marcio P Santana
- Hemocentro de Belo Horizonte, Fundação HEMOMINAS, Belo Horizonte, Brazil
| | - Daniel G Chaves
- Hemocentro de Belo Horizonte, Fundação HEMOMINAS, Belo Horizonte, Brazil
| | - Johanna van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
- Center for Clinical Transfusion Research, Sanquin, Leiden, The Netherlands
| | - Suely M Rezende
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Camelo RM, Caram-Deelder C, Duarte BP, de Moura MCB, Costa NCDM, Costa IM, Roncal CGP, Vanderlei AM, Guimaraes TMR, Gouw S, Rezende SM, van der Bom J. Cardiovascular risk factors among adult patients with haemophilia. Int J Hematol 2021; 113:884-892. [PMID: 33677769 DOI: 10.1007/s12185-021-03104-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/08/2021] [Accepted: 02/18/2021] [Indexed: 11/30/2022]
Abstract
Since the introduction of episodic and prophylactic treatments with safer factor concentrates, the life expectancy of people with haemophilia (PwH) has improved considerably. Ageing-related diseases such as cardiovascular disease (CVD) have also become more prevalent in PwH. This cross-sectional study aimed to evaluate CVD risk factors and estimate 10-year risk for CVD events among PwH. Male patients ≥ 30 years were interviewed and examined. Blood tests were performed at the local laboratory. Eighty-two patients were included, of whom 83% had haemophilia A and half had severe disease. Median age at study entry was 43.0 years (interquartile range [IQR], 36.0-51.3). Prevalence of obesity, systemic arterial hypertension (SAH) and diabetes mellitus were 16%, 60% and 16%, respectively. Hypertriglyceridaemia, hypercholesterolaemia and low HDL blood levels were present in 18%, 41% and 30% of patients, respectively. Metabolic syndrome was found in 37%. The Framingham Risk Score showed that 39% of PwH had a high risk of developing cardiovascular events in the following 10 years. We conclude that, in this cohort, PwH have a higher prevalence of SAH when compared with Brazilian men without haemophilia and about two-fifths have a high risk of developing a CVD event in the following 10 years.
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Affiliation(s)
- Ricardo Mesquita Camelo
- Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 190 2nd Floor, Room 255, Belo Horizonte, MG, 30130-100, Brazil. .,Fundacao de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, Brazil. .,Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands.
| | - Camila Caram-Deelder
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands.,Jon J Van Rood Centre for Clinical Transfusion Research, Sanquin/LUMC, Leiden, The Netherlands
| | - Bruna Pontes Duarte
- Fundacao de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, Brazil
| | | | | | - Iris Maciel Costa
- Fundacao de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, Brazil
| | | | - Ana Maria Vanderlei
- Fundacao de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, Brazil
| | - Tania Maria Rocha Guimaraes
- Fundacao de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, Brazil.,Faculdade de Enfermagem Nossa Senhora das Gracas, Universidade de Pernambuco, Recife, Brazil
| | - Samantha Gouw
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands.,Paediatric Haematology, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands
| | - Suely Meireles Rezende
- Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 190 2nd Floor, Room 255, Belo Horizonte, MG, 30130-100, Brazil
| | - Johanna van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands.,Jon J Van Rood Centre for Clinical Transfusion Research, Sanquin/LUMC, Leiden, The Netherlands
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5
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McCall SJ, Henriquez D, Edwards HM, van den Akker T, Bloemenkamp KWM, van der Bom J, Bonnet MP, Deneux-Tharaux C, Donati S, Gillissen A, Kurinczuk JJ, Li Z, Maraschini A, Seco A, Sullivan E, Stanworth S, Knight M. A total blood volume or more transfused during pregnancy or after childbirth: Individual patient data from six international population-based observational studies. PLoS One 2021; 16:e0244933. [PMID: 33481835 PMCID: PMC7822517 DOI: 10.1371/journal.pone.0244933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/20/2020] [Indexed: 11/18/2022] Open
Abstract
Background This study aimed to compare incidence, management and outcomes of women transfused their blood volume or more within 24 hours during pregnancy or following childbirth. Methods Combined analysis of individual patient data, prospectively collected in six international population-based studies (France, United Kingdom, Italy, Australia, the Netherlands and Denmark). Massive transfusion in major obstetric haemorrhage was defined as transfusion of eight or more units of red blood cells within 24 hours in a pregnant or postpartum woman. Causes, management and outcomes of women with massive transfusion were compared across countries using descriptive statistics. Findings The incidence of massive transfusion was approximately 21 women per 100,000 maternities for the United Kingdom, Australia and Italy; by contrast Denmark, the Netherlands and France had incidences of 82, 66 and 69 per 100,000 maternities, respectively. There was large variation in obstetric and haematological management across countries. Fibrinogen products were used in 86% of women in Australia, while the Netherlands and Italy reported lower use at 35–37% of women. Tranexamic acid was used in 75% of women in the Netherlands, but in less than half of women in the UK, Australia and Italy. In all countries, women received large quantities of colloid/crystalloid fluids during resuscitation (>3·5 litres). There was large variation in the use of compression sutures, embolisation and hysterectomy across countries. There was no difference in maternal mortality; however, variable proportions of women had cardiac arrests, renal failure and thrombotic events from 0–16%. Interpretation There was considerable variation in the incidence of massive transfusion associated with major obstetric haemorrhage across six high-income countries. There were also large disparities in both transfusion and obstetric management between these countries. There is a requirement for detailed evaluation of evidence underlying current guidance. Furthermore, cross-country comparison may empower countries to reference their clinical care against that of other countries.
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Affiliation(s)
- Stephen J. McCall
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Headington, Oxford, United Kingdom
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Riad El Solh, Beirut, Lebanon
- * E-mail:
| | - Dacia Henriquez
- Department of Obstetrics and Gynaecology, Leiden University Medical Centre, Leiden, Netherlands
- Jon J van Rood Center for Clinical Transfusion Research, Sanquin Research & Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Hellen McKinnon Edwards
- Department of Obstetrics and Gynaecology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Thomas van den Akker
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Headington, Oxford, United Kingdom
- Department of Obstetrics and Gynaecology, Leiden University Medical Centre, Leiden, Netherlands
| | - Kitty W. M. Bloemenkamp
- Department of Obstetrics, Birth Centre Wilhelmina’s Children Hospital, Division Woman and Baby, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Johanna van der Bom
- Jon J van Rood Center for Clinical Transfusion Research, Sanquin Research & Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Marie-Pierre Bonnet
- Department of Anaesthesiology and Critical Care, Armand Trousseau Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
- INSERM U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Research Center for Epidemiology and Biostatistics (CRESS), Paris University, Paris, France
| | - Catherine Deneux-Tharaux
- INSERM U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Research Center for Epidemiology and Biostatistics (CRESS), Paris University, Paris, France
| | - Serena Donati
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità - Italian National Institute of Health, Rome, Italy
| | - Ada Gillissen
- Department of Obstetrics and Gynaecology, Leiden University Medical Centre, Leiden, Netherlands
- Jon J van Rood Center for Clinical Transfusion Research, Sanquin Research & Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Jennifer J. Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Headington, Oxford, United Kingdom
| | - Zhuoyang Li
- Faculty of Health and Medicine, The University of Newcastle, Newcastle, Australia
| | - Alice Maraschini
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità - Italian National Institute of Health, Rome, Italy
| | - Aurélien Seco
- Department of Anaesthesiology and Critical Care, Armand Trousseau Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
- Clinical Research Unit of Paris Descartes Necker Cochin, APHP, Paris, France
| | - Elizabeth Sullivan
- Faculty of Health and Medicine, The University of Newcastle, Newcastle, Australia
| | - Simon Stanworth
- Oxford University Hospitals NHS Trust, Department of Haematology, Oxford, United Kingdom
- NIHR BRC Blood Theme, University of Oxford, Oxford, United Kingdom
- NHS Blood and Transplant, John Radcliffe Hospital, Oxford, United Kingdom
| | - Marian Knight
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Headington, Oxford, United Kingdom
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Jardim LL, van der Bom J, Brommonschenkel CC, Gouw SC, Rezende SM. Inhibitor incidence in haemophilia A under exclusive use of a third-generation recombinant factor VIII concentrate: results of the HEMFIL Cohort Study. Br J Haematol 2018; 186:152-155. [PMID: 30556277 DOI: 10.1111/bjh.15728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Letícia L Jardim
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Johanna van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands
| | | | - Samantha C Gouw
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Suely M Rezende
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Hassan S, Fijnvandraat K, van der Bom J, Gouw S. Preventing or Eradicating Factor VIII Antibody Formation in Patients with Hemophilia A: What Can We Learn from Other Disorders? Semin Thromb Hemost 2018; 44:531-543. [DOI: 10.1055/s-0038-1666823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AbstractEradication of factor VIII (FVIII) specific neutralizing antibodies (also known as inhibitors) by the traditional method of immune tolerance induction (ITI) is costly and unsuccessful in one out of three patients. Furthermore, effective inhibitor prevention strategies are presently lacking. An overview is given in this narrative review of antidrug antibody prevention or eradication strategies that have been used in disorders beyond hemophilia A, with the aim of analyzing what we can learn from these strategies for hemophilia A. Prevention of antidrug antibody formation using rituximab, methotrexate, and intravenous immunoglobulins in patients with Pompe's disease seems effective but carries a high risk of adverse events. Based on studies in patients with rheumatoid arthritis and inflammatory bowel disease, it seems likely that treatment with methotrexate alone would also be able to prevent inhibitor formation in hemophilia A patients. Besides side effects, it is unclear whether immune tolerance to FVIII would persist after cessation of immunomodulatory therapy with methotrexate. A combination of cyclophosphamide and corticosteroids, used to treat antibody-mediated pure red cell aplasia, could be further investigated to eradicate inhibitors in hemophilia A patients who are refractory to ITI. In summary, insights gained from research on antidrug antibody formation in other diseases could be helpful in devising alternative treatment strategies for inhibitor development.
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Affiliation(s)
- Shermarke Hassan
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Karin Fijnvandraat
- Department of Pediatric Hematology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
- Department of Plasma Proteins, Sanquin Research, Amsterdam, The Netherlands
| | - Johanna van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
- Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
| | - Samantha Gouw
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Pediatric Hematology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
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8
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Mauser-Bunschoten E, Fischer K, van den Berg M, van der Bom J. Age at first treatment and immune tolerance to factor VIII in severe hemophilia. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613376] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryFindings from a recent study suggest that earlier start of treatment with factor VIII in patients with severe hemophilia is associated with a higher risk to develop inhibitors.We set out to assess the association between age of first administration of clotting factor VIII and the risk to develop inhibitors in infants with severe hemophilia A.This work was a cohort study, carried out in the national hemophilia treatment center. The study included eighty-one consecutive patients with severe hemophilia A who received their first dose of factor VIII between 1975 and 1998. Patients were followed until their last visit in 2001 or 2002.The average follow-up was 16 years (range 3-26). Persistent inhibitory antibodies developed in 12 of 81 patients (15%).Cumulative incidence at 100 exposure days was 34% (95% confidence interval 7-61%) in patients starting therapy before the age of 6 months, 20% (4-36%) in patients starting therapy between 6 months and 1 year, 13% (0-27%) in those starting therapy between 1 and 1.5 years, and 0% in those who started therapy beyond 1.5 years of age (p for trend 0.03).Our findings confirm that age of first factor VIII administration in children with severe hemophilia A is inversely associated with the risk to develop antibodies against factor VIII. The role of confounding factors such as the type of factor VIII mutation and environmental factors needs to be evaluated.
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9
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van der Bom J, Bots M, Haverkate F, Meyer P, Hofman A, Kluft C, Grobbee D. Fibrinolytic Activity in Peripheral Atherosclerosis in the Elderly. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1614457] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryIncreased concentrations of plasminogen activator inhibitor type 1 (PAI-1) and of D-dimer have jointly been found in subjects with cardiovascular disease. To understand this apparent paradox of increased inhibition of fibrinolysis (high PAI-1) combined with increased fibrinolytic activity (high D-dimer), we examined the relation between D-dimer, PAI-1 and the activator of fibrinolysis, tissue type plasminogen activator (t-PA) in subjects with varying severity of peripheral atherosclerosis. In 325 subjects selected from the Rotterdam Study, a cohort of 7983 men and women aged 55 years and over, the ankle to brachial systolic blood pressure ratio, t-PA antigen and activity, PAI-1 antigen and D-dimer were measured.T-PA antigen and t-PA activity were, independent from each other, increased with degree of atherosclerosis; t-PA antigen increased with 3.5 ng/ml (SE 1.7, p = 0.04) and t-PA activity with 0.46 IU/ml (0.20, p = 0.02) per unit decrease in ankle to brachial pressure ratio (i.e. increase in atherosclerosis). PAI-1 antigen was not related to atherosclerosis. More marked atherosclerosis was associated with increased D-dimer, mainly in subgroups with PAI-1 antigen below 50 ng/ml, t-PA antigen below 10 ng/ml, or t-PA activity above 1.5 IU/ml. In contrast to current beliefs, we found that only a fraction of the variation of t-PA antigen was due to the variation in circulating PAI-1 antigen. A slight positive association was observed between t-PA antigen and D-dimer. PAI-1 and t-PA activity were not associated with D-dimer concentration.In conclusion, in subjects with peripheral atherosclerosis PAI-1 antigen is not increased, but low PAI-1 levels (and possibly also low levels of t-PA antigen and high levels of t-PA activity) appear to be required to increase circulating D-dimer. This suggests that increased D-dimer levels in subjects with atherosclerosis do not reflect increased inhibition, but rather reflect increased fibrinolysis.
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de Wee E, Knol H, Mauser-Bunschoten E, van der Bom J, Eikenboom J, Fijnvandraat K, Goede-Bolder AD, Laros-van Gorkom B, Ypma P, Zweegman S, Meijer K, Leebeek F. Gynaecological and obstetric bleeding in moderate and severe von Willebrand disease. Thromb Haemost 2017; 106:885-92. [DOI: 10.1160/th11-03-0180] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 07/29/2011] [Indexed: 12/20/2022]
Abstract
SummaryA nation-wide cross-sectional study was initiated to assess gynaecological and obstetrical symptoms in an unselected cohort of women with moderate and severe von Willebrand disease (VWD) in the Netherlands. A total of 423 women aged ≥16 years were included. Bleeding severity was measured using the Tosetto Bleeding Score (BS). Menorrhagia, defined as occurrence of ≥2 menorrhagia symptoms, was reported by 81%. Of all VWD women, 78% received any kind of treatment for menorrhagia and 20% underwent a hysterectomy predominantly because of severe menstrual bleeding. Over half of the women reported more blood loss than can be expected with a normal delivery. In 52% of reported pregnancy losses curettage was needed because of bleeding. Mean number of live births was 1.9, which is comparable with the general Dutch population. In conclusion, women with moderate or severe VWD frequently have menorrhagia in need of treatment, and 20% of the VWD women underwent a hysterectomy. Bleeding complications occurred in over 50% of the women after childbirth or pregnancy loss. Progeny seems not to be affected in women with moderate or severe VWD.
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van Galen K, Timmer M, de Kleijn P, Fischer K, Foppen W, Schutgens R, Eikenboom J, Meijer K, Cnossen M, Fijnvandraat K, van der Bom J, Larosvan Gorkom B, Leebeek F, Mauser-Bunschoten E. Joint assessment in von Willebrand disease. Thromb Haemost 2017; 117:1465-1470. [DOI: 10.1160/th16-12-0967] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 04/10/2017] [Indexed: 11/05/2022]
Abstract
SummaryAssessment of clinical outcome after joint bleeding is essential to identify joint damage and optimise treatment, to prevent disability. However, disease-specific tools to assess the musculoskeletal status in patients with von Willebrand disease (VWD) are lacking. We aimed to determine validity and reliability of the Haemophilia Joint Health Score (HJHS) and Haemophilia Activities List (HAL) in patients with Von Willebrand disease (VWD). Ninety-six patients with VWD were included (mean age 46 years) of whom 27 had more than five documented joint bleeds. The HJHS was performed in all patients and all patients completed the HAL and Impact on Participation and Autonomy (IPA) questionnaires. Health-related quality of life (SF36) results were obtained from the prior ‘Willebrand in the Netherlands’ study. Joint X-rays of knees, elbows and ankles were scored according to Pettersson (PS). Internal consistency of the HJHS (Cronbach’s α (α)=0.75) and HAL (α=0.89) were good. Inter-observer agreement of the HJHS was good (ICC 0.84; Limits of Agreement ± 10.3). The HJHS showed acceptable correlation with the X-ray PS (Spearman’s r (rs)>0.60 all joints) and HAL (rs=0.71). The HAL also showed acceptable correlation with the SF36 physical functioning (rs=0.65) and IPA (rs=0.69). Hypothesis testing showed adequate discriminative power of both instruments: in patients with a history of >5 versus ≤ 5 joint bleeds (median HJHS 10 vs 2 (p<0.01); median HAL 77 vs 98 (p<0.01)), independent from age. In conclusion, both the HJHS and HAL are feasible to assess clinical outcome after joint bleeds in VWD.
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Saris A, van Oostrom M, Snoep J, Rosendaal F, Zwaginga J, Eikenboom J, van der Meer P, van der Bom J, Bonten T. Effect of aspirin intake at bedtime versus on awakening on circadian rhythm of platelet reactivity. Thromb Haemost 2017; 112:1209-18. [DOI: 10.1160/th14-05-0453] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 07/10/2014] [Indexed: 02/02/2023]
Abstract
SummaryThe risk of acute cardiovascular events is highest during morning hours, and platelet activity peaks during morning hours. The effect of timing of aspirin intake on circadian rhythm and morning peak of platelet reactivity is not known. It was our objective to evaluate the effect of timing of aspirin intake on circadian rhythm and morning peak of platelet reactivity. A randomised open-label cross-over trial in healthy subjects (n=14) was conducted. Participants used acetylsalicylic acid (80 mg) on awakening or at bedtime for two periods of two weeks, separated by a four-week wash-out period. At the end of both periods blood was drawn every 3 hours to measure COX-1-dependent (VerifyNow- Aspirin; Serum Thromboxane B2 [STxB2]) and COX-1-independent (flow cytometry surface CD62p expression; microaggregation) platelet activity. VerifyNow platelet reactivity over the whole day was similar with intake on awakening and at bedtime (mean difference: –9 [95 % confidence interval (CI) –21 to 4]). However, the morning increase in COX-1-dependent platelet activity was reduced by intake of aspirin at bedtime compared with on awakening (mean difference VerifyNow: –23 Aspirin Reaction Units [CI –50 to 4]; STxB2: –1.7 ng/ml [CI –2.7 to –0.8]). COX-1-independent assays were not affected by aspirin intake or its timing. Low-dose aspirin taken at bedtime compared with intake on awakening reduces COX-1-dependent platelet reactivity during morning hours in healthy subjects. Future clinical trials are required to investigate whether simply switching to aspirin intake at bedtime reduces the risk of cardiovascular events during the high risk morning hours.
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Hogervorst E, Rosseel P, van der Bom J, Bentala M, Brand A, van der Meer N, van de Watering L. Tolerance of intraoperative hemoglobin decrease during cardiac surgery. Transfusion 2014; 54:2696-704. [DOI: 10.1111/trf.12654] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 02/18/2014] [Accepted: 02/18/2014] [Indexed: 01/01/2023]
Affiliation(s)
- Esther Hogervorst
- Center for Clinical Transfusion Reseach; Sanquin/LUMC; Leiden the Netherlands
| | | | - Johanna van der Bom
- Center for Clinical Transfusion Reseach; Sanquin/LUMC; Leiden the Netherlands
- Department of Clinical Epidemiology; Leiden University Medical Center; Leiden the Netherlands
| | | | - Anneke Brand
- Center for Clinical Transfusion Reseach; Sanquin/LUMC; Leiden the Netherlands
| | | | - Leo van de Watering
- Center for Clinical Transfusion Reseach; Sanquin/LUMC; Leiden the Netherlands
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Honohan Á, van't Ende E, Hulzebos C, Lopriore E, van't Verlaat E, Govaert P, Brand A, van der Bom J. Posttransfusion platelet increments after different platelet products in neonates: a retrospective cohort study. Transfusion 2013; 53:3100-9. [DOI: 10.1111/trf.12127] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 12/20/2012] [Accepted: 12/20/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Áine Honohan
- Sanquin-LUMC Jon J. van Rood Center for Clinical Transfusion Research; Leiden the Netherlands
- Sanquin Blood Supply Foundation; Amsterdam the Netherlands
- Department of Pediatrics; Division of Neonatology; Beatrix Children's Hospital; University Medical Center; Groningen the Netherlands
- Department of Pediatrics; Division of Neonatology; Department of Clinical Epidemiology; Leiden University Medical Center; Leiden the Netherlands
- Department of Pediatrics; Division of Neonatology; Sophia Children's Hospital; Erasmus Medical Center; Rotterdam the Netherlands
| | - Ella van't Ende
- Sanquin-LUMC Jon J. van Rood Center for Clinical Transfusion Research; Leiden the Netherlands
- Sanquin Blood Supply Foundation; Amsterdam the Netherlands
- Department of Pediatrics; Division of Neonatology; Beatrix Children's Hospital; University Medical Center; Groningen the Netherlands
- Department of Pediatrics; Division of Neonatology; Department of Clinical Epidemiology; Leiden University Medical Center; Leiden the Netherlands
- Department of Pediatrics; Division of Neonatology; Sophia Children's Hospital; Erasmus Medical Center; Rotterdam the Netherlands
| | - Christian Hulzebos
- Sanquin-LUMC Jon J. van Rood Center for Clinical Transfusion Research; Leiden the Netherlands
- Sanquin Blood Supply Foundation; Amsterdam the Netherlands
- Department of Pediatrics; Division of Neonatology; Beatrix Children's Hospital; University Medical Center; Groningen the Netherlands
- Department of Pediatrics; Division of Neonatology; Department of Clinical Epidemiology; Leiden University Medical Center; Leiden the Netherlands
- Department of Pediatrics; Division of Neonatology; Sophia Children's Hospital; Erasmus Medical Center; Rotterdam the Netherlands
| | - Enrico Lopriore
- Sanquin-LUMC Jon J. van Rood Center for Clinical Transfusion Research; Leiden the Netherlands
- Sanquin Blood Supply Foundation; Amsterdam the Netherlands
- Department of Pediatrics; Division of Neonatology; Beatrix Children's Hospital; University Medical Center; Groningen the Netherlands
- Department of Pediatrics; Division of Neonatology; Department of Clinical Epidemiology; Leiden University Medical Center; Leiden the Netherlands
- Department of Pediatrics; Division of Neonatology; Sophia Children's Hospital; Erasmus Medical Center; Rotterdam the Netherlands
| | - Ellen van't Verlaat
- Sanquin-LUMC Jon J. van Rood Center for Clinical Transfusion Research; Leiden the Netherlands
- Sanquin Blood Supply Foundation; Amsterdam the Netherlands
- Department of Pediatrics; Division of Neonatology; Beatrix Children's Hospital; University Medical Center; Groningen the Netherlands
- Department of Pediatrics; Division of Neonatology; Department of Clinical Epidemiology; Leiden University Medical Center; Leiden the Netherlands
- Department of Pediatrics; Division of Neonatology; Sophia Children's Hospital; Erasmus Medical Center; Rotterdam the Netherlands
| | - Paul Govaert
- Sanquin-LUMC Jon J. van Rood Center for Clinical Transfusion Research; Leiden the Netherlands
- Sanquin Blood Supply Foundation; Amsterdam the Netherlands
- Department of Pediatrics; Division of Neonatology; Beatrix Children's Hospital; University Medical Center; Groningen the Netherlands
- Department of Pediatrics; Division of Neonatology; Department of Clinical Epidemiology; Leiden University Medical Center; Leiden the Netherlands
- Department of Pediatrics; Division of Neonatology; Sophia Children's Hospital; Erasmus Medical Center; Rotterdam the Netherlands
| | - Anneke Brand
- Sanquin-LUMC Jon J. van Rood Center for Clinical Transfusion Research; Leiden the Netherlands
- Sanquin Blood Supply Foundation; Amsterdam the Netherlands
- Department of Pediatrics; Division of Neonatology; Beatrix Children's Hospital; University Medical Center; Groningen the Netherlands
- Department of Pediatrics; Division of Neonatology; Department of Clinical Epidemiology; Leiden University Medical Center; Leiden the Netherlands
- Department of Pediatrics; Division of Neonatology; Sophia Children's Hospital; Erasmus Medical Center; Rotterdam the Netherlands
| | - Johanna van der Bom
- Sanquin-LUMC Jon J. van Rood Center for Clinical Transfusion Research; Leiden the Netherlands
- Sanquin Blood Supply Foundation; Amsterdam the Netherlands
- Department of Pediatrics; Division of Neonatology; Beatrix Children's Hospital; University Medical Center; Groningen the Netherlands
- Department of Pediatrics; Division of Neonatology; Department of Clinical Epidemiology; Leiden University Medical Center; Leiden the Netherlands
- Department of Pediatrics; Division of Neonatology; Sophia Children's Hospital; Erasmus Medical Center; Rotterdam the Netherlands
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Honohan Á, Tomson B, van der Bom J, de Vries R, Brand A. A comparison of volume-reduced versus standard HLA/HPA-matched apheresis platelets in alloimmunized adult patients. Transfusion 2011; 52:742-51. [DOI: 10.1111/j.1537-2995.2011.03364.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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