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Guérois C, Laurian Y, Rothschild C, Parquet-Gernez A, Duclos AM, Négrier C, Vicariot M, Fimbel B, Fressinaud E, Fiks-Sigaud M, Derlon A, Berthier AM, Gaillard S, Bertrand MA. Incidence of Factor VIII Inhibitor Development in Severe Hemophilia A Patients Treated only with One Brand of Highly Purified Plasma-Derived Concentrate. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1653753] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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
SummaryThe incidence of factor VIII inhibitor was studied in a cohort of 56 previously untreated patients with severe hemophilia A (factor VIII below 1 U/dl). They received only one brand of highly purified factor VIII concentrate (HPSD-VIII) prepared by conventional chromatography with a solvent-detergent step for viral inactivation. Followup since the first infusion of HPSD-VIII was from 1 to 76 months (mean = 29) and cumulative exposure days (CED) from 1 to over 100 (median = 26). Five patients (9%) developed an inhibitor after 6 to 19 CED, only one being a high responder (2%), showing a low incidence of inhibitor compared with previous studies using high purity plasma- derived or recombinant products.
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Affiliation(s)
- Claude Guérois
- The Hemophilia Centers of Tours, Bicêtre, Paris-Necker, Lille, Clermont-Ferrand, Lyon, Brest, Angers, Nantes, Caen, Rennes-La Bouexière, Limoges et Besançon, France
| | - Yves Laurian
- The Hemophilia Centers of Tours, Bicêtre, Paris-Necker, Lille, Clermont-Ferrand, Lyon, Brest, Angers, Nantes, Caen, Rennes-La Bouexière, Limoges et Besançon, France
| | - Chantal Rothschild
- The Hemophilia Centers of Tours, Bicêtre, Paris-Necker, Lille, Clermont-Ferrand, Lyon, Brest, Angers, Nantes, Caen, Rennes-La Bouexière, Limoges et Besançon, France
| | - Armelle Parquet-Gernez
- The Hemophilia Centers of Tours, Bicêtre, Paris-Necker, Lille, Clermont-Ferrand, Lyon, Brest, Angers, Nantes, Caen, Rennes-La Bouexière, Limoges et Besançon, France
| | - Anne-Marie Duclos
- The Hemophilia Centers of Tours, Bicêtre, Paris-Necker, Lille, Clermont-Ferrand, Lyon, Brest, Angers, Nantes, Caen, Rennes-La Bouexière, Limoges et Besançon, France
| | - Claude Négrier
- The Hemophilia Centers of Tours, Bicêtre, Paris-Necker, Lille, Clermont-Ferrand, Lyon, Brest, Angers, Nantes, Caen, Rennes-La Bouexière, Limoges et Besançon, France
| | - Monique Vicariot
- The Hemophilia Centers of Tours, Bicêtre, Paris-Necker, Lille, Clermont-Ferrand, Lyon, Brest, Angers, Nantes, Caen, Rennes-La Bouexière, Limoges et Besançon, France
| | - Béatrice Fimbel
- The Hemophilia Centers of Tours, Bicêtre, Paris-Necker, Lille, Clermont-Ferrand, Lyon, Brest, Angers, Nantes, Caen, Rennes-La Bouexière, Limoges et Besançon, France
| | - Edith Fressinaud
- The Hemophilia Centers of Tours, Bicêtre, Paris-Necker, Lille, Clermont-Ferrand, Lyon, Brest, Angers, Nantes, Caen, Rennes-La Bouexière, Limoges et Besançon, France
| | - Marianne Fiks-Sigaud
- The Hemophilia Centers of Tours, Bicêtre, Paris-Necker, Lille, Clermont-Ferrand, Lyon, Brest, Angers, Nantes, Caen, Rennes-La Bouexière, Limoges et Besançon, France
| | - Annie Derlon
- The Hemophilia Centers of Tours, Bicêtre, Paris-Necker, Lille, Clermont-Ferrand, Lyon, Brest, Angers, Nantes, Caen, Rennes-La Bouexière, Limoges et Besançon, France
| | - Anne-Marie Berthier
- The Hemophilia Centers of Tours, Bicêtre, Paris-Necker, Lille, Clermont-Ferrand, Lyon, Brest, Angers, Nantes, Caen, Rennes-La Bouexière, Limoges et Besançon, France
| | - Solange Gaillard
- The Hemophilia Centers of Tours, Bicêtre, Paris-Necker, Lille, Clermont-Ferrand, Lyon, Brest, Angers, Nantes, Caen, Rennes-La Bouexière, Limoges et Besançon, France
| | - Marie-Anne Bertrand
- The Hemophilia Centers of Tours, Bicêtre, Paris-Necker, Lille, Clermont-Ferrand, Lyon, Brest, Angers, Nantes, Caen, Rennes-La Bouexière, Limoges et Besançon, France
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Affiliation(s)
- Yves Laurian
- Hemophilia Center, Hopital Bicêtre, 94270 Kremlin-Bicetre, France Hemophilia Centers of Detroit MI 48201 and Washington DC 2007, USA
| | - Jeanne M Lusher
- Hemophilia Center, Hopital Bicêtre, 94270 Kremlin-Bicetre, France Hemophilia Centers of Detroit MI 48201 and Washington DC 2007, USA
| | - Craig M Kessler
- Hemophilia Center, Hopital Bicêtre, 94270 Kremlin-Bicetre, France Hemophilia Centers of Detroit MI 48201 and Washington DC 2007, USA
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Ménart C, Trzeciak MC, Nurden P, Fressinaud E, Dreyfus M, Laurian Y, Négrier C, d’Oiron R. Use of Recombinant Factor VIIa in 3 Patients with Inherited Type I Glanzmann’s Thrombasthenia Undergoing Invasive Procedures. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613884] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [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
SummaryThe treatment of bleeds in Glanzmann’s thrombasthenia is a challenging issue, especially when repeated platelet transfusions have induced anti-glycoprotein (GP) IIb-IIIa or anti-HLA allo-immunisation. In an attempt to find an alternative treatment regimen, we used recombinant factor VIIa (rFVIIa, NovoSeven®, Novo Nordisk, Denmark) as first-line therapy in 3 patients with Glanzmann’s thrombasthenia and anti-GPIIb-IIIa iso-antibodies who were scheduled for invasive procedures. The administration of an initial bolus dose of rFVIIa (70–110 µg/kg) was immediately followed by continuous infusion at the rate of 9-30 µg/kg/h for 3–15 days. The treatment resulted in an excellent clinical efficacy and tolerance in 2 cases. In the third patient, whereas efficacy was excellent at the surgical site, pharyngonasal bleeds of traumatic origin persisted for 10 days, and a severe thromboembolic complication occurred 5 days after discontinuation of rFVIIa. Complementary studies are needed for patients with congenital platelet disorders in order to evaluate the safety and the potential therapeutic place of rFVIIa treatment.
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Laurian Y, Satre EP, Derlon AB, Chambost H, Moreau P, Goudemand J, Parquet A, Peynet J, Vicariot M, Beurrier P, Claeyssens S, Durin A, Faradji A, Fressinaud E, Gaillard S, Guérin V, Guérois C, Pernod G, Pouzol P, Schved JF, Gazengel C, Rothschild C. French Previously Untreated Patients with Severe Hemophilia A after Exposure to Recombinant Factor VIII : Incidence of Inhibitor and Evaluation of Immune Tolerance. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1615358] [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] [Indexed: 10/17/2022]
Abstract
SummaryFifty French previously untreated patients with severe hemophilia A (factor VIII <1%), treated with only one brand of recombinant factor VIII (rFVIII), were evaluated for inhibitor development, assessment of risk factors and outcome of immune tolerance regimen. The median period on study was 32 months (range 9-74) since the first injection of rFVIII. Fourteen patients (28%) developed an inhibitor, four of whom (8%) with a high titer (≥10 BU). All inhibitor patients but one continued to receive rFVIII either for on-demand treatment or for immune tolerance regimen (ITR). Among these patients, inhibitor was transient in 2 (4%), became undetectable in 6 and was still present in 6. The prevalence of inhibitor was 12%. Presence of intron 22 inversion was found to be a risk factor for inhibitor development. Immune tolerance was difficult to achieve in our series despite a follow-up period of 16 to 30 months: immune tolerance was complete in only one out of the 3 patients undergoing low dose ITR and in one out of the 5 patients with high dose ITR.
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Fiks-Sigaud M, Bendelac L, Parquet A, Verroust F, Torchet M, Berthier A, Fressinaud E, Guerois C, Aillaud M, Boneu B, Derlon A, Subtil E, Bertrand M, Borg J, Laurian Y. Comparison of Anti-Human and Anti-Porcine Factor VIII Inhibitor Levels in 63 Patients with Severe Haemophilia A. Vox Sang 2017. [DOI: 10.1159/000462354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Salvado C, Mekinian A, Gerin M, Boukari L, Morin AS, Laurian Y, Stirnemann J, Fain O. Hémophilie acquise associée à une maladie de Biermer. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.10.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 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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Ghnaya H, Eymard F, Morin A, Boukari L, Ora J, Stirnemann J, Laurian Y, Fain O. Hémophilie acquise du sujet âgé : efficacité du rituximab. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 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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Desmarres C, Laurian Y. From top to toe. An alternative approach to physiotherapy for hemophiliacs. Scand J Haematol Suppl 2009; 40:469-70. [PMID: 6591405 DOI: 10.1111/j.1600-0609.1984.tb02603.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Bibi-Triki T, Aras N, Braun T, Lautridou C, Boukari L, Morin A, Maquarre E, Stirnemann J, Brichler S, Laurian Y, Fain O. Plasmocytose sanguine et médullaire au cours de la dengue : une observation. Rev Med Interne 2009; 30:274-6. [DOI: 10.1016/j.revmed.2008.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2008] [Revised: 05/05/2008] [Accepted: 05/08/2008] [Indexed: 10/21/2022]
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Toledano A, Lachassinne E, Roumegoux C, Laurian Y, Benabadji Z, Chiadmi F, Cisternino S, Schlatter J, Fontan JE. Treatment of Congenital Afibrinogenemia in a Premature Neonate. Ann Pharmacother 2008; 42:1145-6. [DOI: 10.1345/aph.1l132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Audrey Toledano
- Department of Pharmacy and Toxicology University Hospital of Jean Verdier Bondy, France
| | | | | | - Yves Laurian
- Department of Hematology and Medical University Paris 13 University Hospital of Jean Verdier
| | - Zahira Benabadji
- Department of Pharmacy and Toxicology University Hospital of Jean Verdier
| | - Fouad Chiadmi
- Department of Pharmacy and Toxicology University Hospital of Jean Verdier
| | | | - Joël Schlatter
- Department of Pharmacy and Toxicology University Hospital of Jean Verdier Assistance Publique–Hôpitaux de Paris (AP-HP) Avenue du 14 juillet 93140 Bondy, France
| | - Jean-Eudes Fontan
- Department of Pharmacy and Toxicology University Hospital of Jean Verdier
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d'Audigier C, Pasmant E, Bournier O, Laurian Y, Guillin MC, Bezeaud A. A natural variant with a point mutation resulting in a homozygous Arg to His substitution at position 388 in prothrombin. Haematologica 2008; 93:799-800. [DOI: 10.3324/haematol.12520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Calvez T, Laurian Y, Goudemand J. Inhibitor incidence with recombinant vs. plasma-derived FVIII in previously untreated patients with severe hemophilia A: homogeneous results from four published observational studies. J Thromb Haemost 2008; 6:390-2. [PMID: 18036187 DOI: 10.1111/j.1538-7836.2008.02852.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Calvez T, Laurian Y, Goudemand J. Inhibitor incidence with recombinant vs. plasma-derived FVIII in previously untreated patients with severe hemophilia A: homogeneous results from four published observational studies. J Thromb Haemost 2007; 6:390-2. [PMID: 18036187 DOI: 10.1111/j.1538-7836.2007.02852.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Calvez T, Laurian Y, Goudemand J. Associations between type of product and inhibitors in previously untreated patients (PUPs) with severe hemophilia: switches and particular products can disturb analysis. Blood 2007; 110:1073-4; author reply 1074-5. [PMID: 17644742 DOI: 10.1182/blood-2007-03-079723] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
PURPOSE OF REVIEW Inhibitors in haemophilia are a serious complication that may render usual replacement therapy ineffective. The risk is greatest in previously untreated children with severe haemophilia A. The role of replacement factor VIII in this group is an important issue. RECENT FINDINGS Until now, few clinical studies have correctly taken into account the variety of cofactors involved in inhibitor development: genetic (familial antecedents, ethnicity, F8 and immune response genotypes), and environmental cofactors (age at first infusion, prophylaxis and intensity of treatment). This is a prerequisite to correctly evaluating the putative role of the type of factor replacement. Prospective cohort studies are therefore urgently needed. Depending on the expected inhibitor risk in the reference group, the intensity of the relationship between risk factor and endpoint, the duration of patient follow up, and the design of the study (balanced or unbalanced groups), cohorts including 200-500 previously untreated children should be sufficient to demonstrate an increased intensity of risk of about 2 or more with one product compared with another. SUMMARY Aside from clinical studies, fundamental research is essential to test the multiple hypotheses that could explain a difference in inhibitor risk between the currently available factor VIII concentrates in order to develop less immunogenic factor VIII.
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Guillet B, Lambert T, d'Oiron R, Proulle V, Plantier JL, Rafowicz A, Peynet J, Costa JM, Bendelac L, Laurian Y, Lavergne JM. Detection of 95 novel mutations in coagulation factor VIII gene F8 responsible for hemophilia A: results from a single institution. Hum Mutat 2006; 27:676-85. [PMID: 16786531 DOI: 10.1002/humu.20345] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [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: 11/08/2022]
Abstract
Hemophilia A (HA) is an X-linked hereditary bleeding disorder defined by a qualitative and/or quantitative factor VIII (FVIII) deficiency. The molecular diagnosis of HA is challenging because of the high number of different causative mutations that are distributed throughout the large F8 gene. The putative role of the novel mutations, especially missense mutations, may be difficult to interpret as causing HA. We identified 95 novel mutations out of 180 different mutations responsible for HA in 515 patients from 406 unrelated families followed up at a single hemophilia treatment center of the Bicêtre university hospital (Assistance Publique-Hôpitaux de Paris [AP-HP], Le Kremlin-Bicêtre). These 95 novel mutations comprised 55 missense mutations, 12 nonsense mutations, 11 splice site mutations, and 17 small insertions/deletions. We therefore developed a mutation analysis based on a body of proof that combines the familial segregation of the mutation, the resulting biological and clinical HA phenotype, and the molecular consequences of the amino acid (AA) substitution. For the latter, we studied the putative biochemical modifications: its conservation status with cross-species FVIII and homologous proteins, its putative location in known FVIII functional regions, and its spatial position in the available FVIII 3D structures. The usefulness of such a strategy in interpreting the causality of novel F8 mutations is emphasized.
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Affiliation(s)
- Benoît Guillet
- Centre de traitement des hémophiles, Laboratoire d'Hématologie, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France.
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Calvez T, Laurian Y. Protective effect of prophylaxis on inhibitor development in children with haemophilia A: more convincing studies are required. Br J Haematol 2006; 132:798-800; author reply 800-1. [PMID: 16487187 DOI: 10.1111/j.1365-2141.2006.05989.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Poon MC, Zotz R, Di Minno G, Abrams ZS, Knudsen JB, Laurian Y. Glanzmann’s Thrombasthenia Treatment: A Prospective Observational Registry on the Use of Recombinant Human Activated Factor VII and Other Hemostatic Agents. Semin Hematol 2006; 43:S33-6. [PMID: 16427383 DOI: 10.1053/j.seminhematol.2005.11.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [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: 11/11/2022]
Abstract
Glanzmann's thrombasthenia (GT) is a rare congenital bleeding disorder caused by deficiency or dysfunction of platelet surface glycoprotein (GP) IIb/IIIa receptor. Platelet transfusion is the standard treatment for bleeding that remains non-responsive to conservative measures, and for surgical coverage. Platelet transfusions, however, may result in the development of antibodies to GPIIb/IIIa and/or human leukocyte antigen (HLA), rendering further transfusions ineffective. Recombinant human activated factor VII (rFVIIa; NovoSeven/Niastase [Canada], Novo Nordisk, Bagsvaerd, Denmark) has documented efficacy in GT patients, and is approved in the European Union for the treatment of GT patients with platelet antibodies and platelet refractoriness. However, there are insufficient data to determine the optimal rFVIIa regimen (eg, for major surgery) or to allow thorough safety evaluation (eg, thrombotic risk). A post-marketing, prospective, observational, multinational registry has been developed to collect data on the efficacy and safety of rFVIIa in the treatment and prevention of bleeding in GT patients with platelet antibodies or platelet refractoriness. Patients treated with other hemostatic agents or rFVIIa to avoid the development of antibodies against GPIIb/IIIa will also be reported. Standardized data will be collected using a customized internet-based (www.glanzmann-reg.org) data collection tool. Data collection will begin in 2005 and continue for up to 6 years. Patients of all ages from any country are eligible for inclusion.
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Affiliation(s)
- Man-Chiu Poon
- University of Calgary, Southern Alberta Hemophilia Clinic, Calgary Health Region, Canada.
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Goudemand J, Rothschild C, Demiguel V, Vinciguerrat C, Lambert T, Chambost H, Borel-Derlon A, Claeyssens S, Laurian Y, Calvez T. Influence of the type of factor VIII concentrate on the incidence of factor VIII inhibitors in previously untreated patients with severe hemophilia A. Blood 2006; 107:46-51. [PMID: 16166584 DOI: 10.1182/blood-2005-04-1371] [Citation(s) in RCA: 239] [Impact Index Per Article: 13.3] [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: 11/20/2022] Open
Abstract
Abstract
Inhibitor development is the major treatment complication in children with severe hemophilia A. It is not clear whether the risk of inhibitors is higher with recombinant factor VIII or with plasma-derived factor VIII. We used multivariate analysis to compare 2 cohorts of previously untreated patients (PUPs) with severe hemophilia A: 62 patients treated with the same brand of high-purity plasma-derived FVIII (pFVIII) containing von Willebrand factor (VWF) and 86 patients treated with full-length recombinant FVIII (rFVIII). In addition to the usual end points (all inhibitors, high inhibitors), we also examined a third end point (high inhibitors and/or immune tolerance induction). The risk of inhibitor development was higher in patients treated with rFVIII than in patients treated with pFVIII, regardless of other risk factors (F8 genotype; nonwhite origin; history of inhibitors in patients with a family history of hemophilia; age at first FVIII infusion). The adjusted relative risk (RRa) for inhibitor development with rFVIII versus pFVIII was 2.4 (all inhibitors), 2.6 (high inhibitors), and 3.2 (high inhibitors and/or immune tolerance induction), respectively, depending on the end point (above). The pathophysiology of this large effect must be understood in order to improve the characteristics of recombinant products and to reduce the incidence of inhibitors to FVIII.
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Affiliation(s)
- Jenny Goudemand
- Hemophilia Treatment Center, University of Lille2, Lille, France.
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Laurian Y, Tisseron-Maury B, Bibi Triki T, Kaplan C, Gaudelus J. Red blood cell transfusion in patients with type 1 Glanzmann's thrombasthenia. J Thromb Haemost 2005; 3:2346-7. [PMID: 16194208 DOI: 10.1111/j.1538-7836.2005.01579.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Regnault V, Briquel ME, Nguyen P, Laurian Y, Béguin S, Hemker HC, Lecompte T. Thrombinography can differentiate bleeding from nonbleeding patients with prolonged APTT. J Thromb Haemost 2003. [DOI: 10.1111/j.1538-7836.2003.tb05474.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 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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Laurian Y. Treatment of bleeding in patients with platelet disorders: is there a place for recombinant factor VIIa? Pathophysiol Haemost Thromb 2003; 32 Suppl 1:37-40. [PMID: 12214146 DOI: 10.1159/000057300] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The mechanism of action of recombinant factor VIIa (rFVIIa), i.e. increased thrombin generation on the membrane of activated platelets, as well as the results from in vitro and ex vivo models of thrombocytopenia or inherited thrombocytopathia may support some potential of rFVIIa in thrombocytopenia/thrombocytopathia. rFVIIa was reported as effective to stop or to decrease bleeding in few patients with severe thrombocytopenia resistant to platelet transfusions; however data are still scarce and clinical studies are really needed to define efficacy/safety ratio as well as optimal treatment regimen in this potential indication. Some data in patients with Glanzmann thrombasthenia (GT) may support the use of rFVIIa outside its primary indication in the cases in which there is no real treatment alternative (GT patients with antibodies to GP IIb-IIIa or with platelet refractoriness).
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Affiliation(s)
- Yves Laurian
- Novo Nordisk Pharmaceutique SA, Boulogne-Billancourt, France.
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Guillet B, Kriaa F, Huysse MG, Proulle V, George C, Tchernia G, D'Oiron R, Laurian Y, Charpentier B, Lambert T, Dreyfus M. Protein A sepharose immunoadsorption: immunological and haemostatic effects in two cases of acquired haemophilia. Br J Haematol 2001; 114:837-44. [PMID: 11564072 DOI: 10.1046/j.1365-2141.2001.03022.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [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: 11/20/2022]
Abstract
Acquired haemophilia is a life-threatening disorder caused by circulating auto-antibodies that inhibit factor VIII coagulant activity (FBIII:C). Immunoadsorption on protein A sepharose (IA-PA) was performed in two bleeding patients with acquired haemophilia: we observed a dramatic and quick decrease in the anti-FVIII:C inhibitor titre leading to a normal, albeit transient, haemostatic status. In one case, IA-PA was the only procedure which succeeded in stopping massive haemorrhage. In the second case, IA-PA reinforced the haemostatic effect of recombinant activated factor VII by increasing the endogenous plasma factor VIII level. The efficacy of IA-PA was sustained with immunosuppressive treatment introduced, respectively, 10 and 15 d before the IA-PA procedures. Our experience with IA-PA suggests that this extracorporeal anti-FVIII:C removal procedure is a valuable therapeutic tool for acquired haemophilia and can alleviate life-threatening haemorrhages.
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Affiliation(s)
- B Guillet
- Laboratoire d'Hématologie et Centre de Référence et de Traitement de l'Hémophilie, Hôpital Bicêtre, AP-HP et Faculté de Médecine Paris XI, 94275 Le Kremlin-Bicêtre, Paris, France
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Calvez T, Biou M, Costagliola D, Jullien AM, Laurian Y, Rossi F, Rothschild C, Sié P. The French haemophilia cohort: rationale and organization of a long-term national pharmacosurveillance system. Haemophilia 2001; 7:82-8. [PMID: 11136385 DOI: 10.1046/j.1365-2516.2001.00457.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [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: 11/20/2022]
Abstract
Medicinal products of biological origin still carry a specific iatrogenic risk, mainly because of their starting material, mode of preparation and variability. Careful postmarketing surveillance systems are therefore necessary. To assess the long-term safety of haemophilia treatment with plasma-derived and recombinant clotting factor products, a cohort study was set up in France in 1994. Participants were patients with haemophilia A and B, with or without previous clotting factor therapy. Clinical events, treatments, biological data and adverse events were recorded on standard forms. Blood samples were separated into serum, plasma and peripheral blood mononuclear cells, frozen, and banked in a central laboratory. The same data and samples were collected at yearly follow-up visits. As of December 1999, 1234 haemophiliacs were enrolled in 39 haemophilia centres. At enrollment, 50.2% of patients were under 15 years of age, and the cumulative number of days of exposure to the product was below 50 in 35.1% of cases. The median duration of follow-up was 26.9 months, with a total of 2729 patient-years (135,947 days of exposure and 211 million units of factor VIII or IX). To date, only 17 patients were lost to follow-up. The initial results show good compliance with this health-watch policy among patients and clinicians specializing in haemophilia. The regular follow-up data and centralized sample bank will serve to investigate rapidly any suspected outbreaks as soon as reliable biological tests become available in the future.
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Affiliation(s)
- T Calvez
- Faculté de Médecine de Saint-Antoine, Paris, France.
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Benoit G, Lambert T, Blanchet P, Laurian Y, Lasjaunias P, D'Oiron R, Eschwege P, Langloys J, Droupy S, Kriaa F, Jardin A. [Which urologic treatment alternatives are there for the hemophiliac patient?]. Prog Urol 2000; 10:388-96. [PMID: 10951931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Urological procedures are hazardous for hemophilic patients. The aim of this work is to report the treatment of 22 hemophilic patients in order to define prognosis factors and treatment options. MATERIAL AND METHODS 22 patients have been treated: 8 had severe hemophilia, 5 A (FVIII < 1%), 3 B (F IX < 1%), 2 had moderate hemophilia A (FVIII 2 to 6%) and 10 minor hemophilia A (F VIII 7 to 30%). Two had acquired hemophilia with auto-anti-FVIII antibodies (ab). Four patients were HIV+. Eighteen patients were first referred to our hospital, and 3 were transferred from an other institution for persistent hematuria: one with anuria, one after bladder neck incision, and the other following suprapubic prostatectomy. RESULTS For patients without FVIII ab, a sufficient level of FVIII or IX (> 60%), could be achieved pre-operatively and maintained post operatively (4 to 20 days, according to the surgical procedure) by injections of FVIII, FIX or by injections of desmopressin. For one haemophilia A patient with anti-F VIII ab, transferred for uncontrollable bleeding after bladder neck incision, selective arterial embolization was successful. But for 2 patients with acquired haemophilia, improvement of the coagulation was insufficient, with human or porcine FVIII, activated prothombic complex concentrates or recombinant activated FVII. In spite of surgical procedures and arterial embolizations the 2 patients died. CONCLUSION The urological treatment of haemophilic patients needs to be performed in specialised centers. For patients without FVIII ab, classical urological procedures can be performed. But for patients with FVIII ab when alternative treatments (radiotherapy, LHRH agonists) can be used, the surgical procedures must be delayed; in emergency if hemostasis cannot be achieved arterial embolization could be useful.
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Affiliation(s)
- G Benoit
- Service d'Urologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, France. www.uro.bicêtre.org
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d'Oiron R, Ménart C, Trzeciak MC, Nurden P, Fressinaud E, Dreyfus M, Laurian Y, Négrier C. Use of recombinant factor VIIa in 3 patients with inherited type I Glanzmann's thrombasthenia undergoing invasive procedures. Thromb Haemost 2000; 83:644-7. [PMID: 10823254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The treatment of bleeds in Glanzmann's thrombasthenia is a challenging issue, especially when repeated platelet transfusions have induced anti-glycoprotein (GP) IIb-IIIa or anti-HLA allo-immunisation. In an attempt to find an alternative treatment regimen, we used recombinant factor VIIa (rFVIIa, NovoSeven, Novo Nordisk, Denmark) as first-line therapy in 3 patients with Glanzmann's thrombasthenia and anti-GPIIb-IIIa iso-antibodies who were scheduled for invasive procedures. The administration of an initial bolus dose of rFVIIa (70-110 microg/kg) was immediately followed by continuous infusion at the rate of 9-30 microg/kg/h for 3-15 days. The treatment resulted in an excellent clinical efficacy and tolerance in 2 cases. In the third patient, whereas efficacy was excellent at the surgical site, pharyngonasal bleeds of traumatic origin persisted for 10 days, and a severe thromboembolic complication occurred 5 days after discontinuation of rFVIIa. Complementary studies are needed for patients with congenital platelet disorders in order to evaluate the safety and the potential therapeutic place of rFVIIa treatment.
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Affiliation(s)
- R d'Oiron
- The Haemophilia Center, Hôpital Bicêtre, Paris Sud, France.
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Parquet A, Laurian Y, Rothschild C, Navarro R, Guérois C, Gay V, Durin A, Peynet J, Sultan Y. Incidence of factor IX inhibitor development in severe haemophilia B patients treated with only one brand of high purity plasma derived factor IX concentrate. Thromb Haemost 1999; 82:1247-9. [PMID: 10544907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Fifteen previously untreated patients (Pups) with severe haemophilia B (factor IX activity < or = 2 U/dl) only treated with one brand of plasma-derived high purity factor IX concentrate (FIX LFB) were studied. Age at first injection varied from 1 to 137 months and follow-up since this first injection from 21 to 86 months (median: 35). Cumulative exposure days (CED) were from 4 to over 100 (median: 26). Among these 15 Pups only one developed an inhibitor. Mutation analysis performed in all patients showed total gene deletion in the patient with inhibitor, partial gene deletion in another one, and missense mutations in 9 families. Mutation was not found in one patient. Actually, according to the data already published, only two patients were at high risk for inhibitor development in our population. Our study, although rather small, confirms the previously reported low incidence of inhibitors in haemophilia B. Large studies on incidence of FIX inhibitors are indeed difficult to perform, due to both the overall small number of severe haemophilia B patients and the low incidence of FIX inhibitors. Consequently, the impact of bias, such as prevalence of different types of gene defects in a given population, is major. Therefore, any study, dealing with incidence of FIX inhibitors in severe haemophilia B should report, for each patient, the type of gene defect.
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Affiliation(s)
- A Parquet
- Haemophilia Centre of ETS-Lille, France
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Reber G, Aurousseau MH, Dreyfus M, Delahousse B, Caron C, Trzeciack MC, Aillaud MF, Horellou MH, Laurian Y, Si P. Inter-laboratory variability of the measurement of low titer factor VIII:C inhibitor in haemophiliacs: improvement by the Nijmegen modification of the Bethesda assay and the use of common lyophilized plasmas. Haemophilia 1999; 5:292-3. [PMID: 10469186 DOI: 10.1046/j.1365-2516.1999.00329.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Arnauld C, Legeay O, Laurian Y, Thiery R, Denis M, Blanchard P, Jestin A. Development of a PCR-based method coupled with a microplate colorimetric assay for the detection of Porcine Parvovirus and application to diagnosis in piglet tissues and human plasma. Mol Cell Probes 1998; 12:407-16. [PMID: 9843658 DOI: 10.1006/mcpr.1998.0205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [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: 11/22/2022]
Abstract
A new method for Porcine Parvovirus (PPV) diagnosis was developed. The method is based on polymerase chain reaction (PCR) amplification followed by hybridization and colorimetric detection of PCR products in microwell plates. A highly specific and sensitive amplification step was ensured by primers carefully selected in the VP2 structural gene and optimized PCR conditions. Uracyl-DNA-Glycosylase (UDG) in combination with dUTP was used to avoid false-positive results, and 100 copies of internal control (IC) were added to each PCR reaction to reveal any false-negative samples. Biotinylated amplified fragments were hybridized on specific capture probes covalently linked to microwell plates. Finally, the detection of hybridized PCR products was performed by means of a colorimetric reaction, which was automated. The method permitted the detection of 10(3) copies (6 fg) of replicative form DNA (RF-DNA) in 20 mg of lung sample, and 500 copies (3 fg) in 100 microl of plasma. It was used to analyse 24 field piglet tissue samples, and 35 human plasma or serum specimens collected from patients treated with porcine Factor VIII concentrates.
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Affiliation(s)
- C Arnauld
- Centre National d'Etudes Vétérinaires et Alimentaires (CNEVA), Unité de Biologie Moléculaire, BP 53, Ploufragan, 22 440, France
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Rothschild C, Laurian Y, Satre EP, Borel Derlon A, Chambost H, Moreau P, Goudemand J, Parquet A, Peynet J, Vicariot M, Beurrier P, Claeyssens S, Durin A, Faradji A, Fressinaud E, Gaillard S, Guérin V, Guérois C, Pernod G, Pouzol P, Schved JF, Gazengel C. French previously untreated patients with severe hemophilia A after exposure to recombinant factor VIII : incidence of inhibitor and evaluation of immune tolerance. Thromb Haemost 1998; 80:779-83. [PMID: 9843171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Fifty French previously untreated patients with severe hemophilia A (factor VIII < 1%), treated with only one brand of recombinant factor VIII (rFVIII), were evaluated for inhibitor development, assessment of risk factors and outcome of immune tolerance regimen. The median period on study was 32 months (range 9-74) since the first injection of rFVIII. Fourteen patients (28%) developed an inhibitor, four of whom (8%) with a high titer (> or = 10 BU). All inhibitor patients but one continued to receive rFVIII either for on-demand treatment or for immune tolerance regimen (ITR). Among these patients, inhibitor was transient in 2 (4%), became undetectable in 6 and was still present in 6. The prevalence of inhibitor was 12%. Presence of intron 22 inversion was found to be a risk factor for inhibitor development. Immune tolerance was difficult to achieve in our series despite a follow-up period of 16 to 30 months: immune tolerance was complete in only one out of the 3 patients undergoing low dose ITR and in one out of the 5 patients with high dose ITR.
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Affiliation(s)
- C Rothschild
- Hemophilia Center of Paris-Necker, Bicêtre, France
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Lusher JM, Roberts HR, Davignon G, Joist JH, Smith H, Shapiro A, Laurian Y, Kasper CK, Mannucci PM. A randomized, double-blind comparison of two dosage levels of recombinant factor VIIa in the treatment of joint, muscle and mucocutaneous haemorrhages in persons with haemophilia A and B, with and without inhibitors. rFVIIa Study Group. Haemophilia 1998; 4:790-8. [PMID: 10028299 DOI: 10.1046/j.1365-2516.1998.00209.x] [Citation(s) in RCA: 173] [Impact Index Per Article: 6.7] [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: 11/20/2022]
Abstract
Recombinant factor VIIa (rFVIIa) was developed to provide an improved procoagulant component capable of 'by-passing' inhibitor antibodies in the treatment of haemophilic patients. The primary objective of this study was to compare the efficacy of two dosage regimens of rFVIIa (given intravenously at periodic intervals) in the treatment of joint, muscle and mucocutaneous haemorrhages in persons with haemophilia A and B with and without inhibitors. The study was designed as a randomized, double-blind, parallel group, international multicenter trial. Patients were randomly allocated to treatment A: 35 mu kg-1 or B: 70 mu kg-1, in blocks of 2. Within each block, one patient was assigned to the 35 mu kg-1 dosing regimen and the other to 70 mu kg-1 dose. One hundred and fifty subjects from 20 sites were screened for this study and 116 had baseline assessments. Of these, 84 were treated on the protocol and 32 were not treated in the study, in most cases because they did not return to the clinic with an eligible bleeding episode. One hundred and seventy-nine bleeding episodes were treated, of which 145 (81%) were acute haemarthroses. Both treatments were efficacious, with 71% having an excellent (59% and 60%) or effective (12% and 11%) response. Overall, the mean and median number of doses given per episode of joint bleeding were 3.1 and 2, respectively. The mean number of doses was 3.1 for the 70 mu kg-1 group and 2.7 for the 35 mu kg-1 group (P value = 0.142). The study concluded that rFVIIa in a dosage of 35 mu kg-1 or 70 mu kg-1 is both safe and reasonably effective in the treatment of joint or muscle haemorrhages in haemophilic patients with inhibitor antibodies to factor VIII or factor IX. It is concluded that the appropriate dose for the treatment of joint and peripheral muscle bleeding in haemophilic patients with inhibitors is 35-70 mu kg-1 given at 2-3 h intervals until haemostasis is achieved.
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Affiliation(s)
- J M Lusher
- Children's Hospital of Michigan, Detroit, USA
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Carré N, Boufassa F, Hubert JB, Chavance M, Rouzioux C, Goujard C, Laurian Y, Meyer L. Predictive value of viral load and other markers for progression to clinical AIDS after CD4+ cell count falls below 200/microL. SEROCO & HEMOCO Study Group. Int J Epidemiol 1998; 27:897-903. [PMID: 9839750 DOI: 10.1093/ije/27.5.897] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [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: 11/14/2022] Open
Abstract
BACKGROUND To assess the predictive value of biological and clinical events for progression to AIDS (1993 European classification) when the CD4+ cell count falls below 200/microL (CD4 threshold) in different exposure groups. To investigate whether such markers remain predictive independently of the serum HIV-1 RNA level at the CD4 threshold. METHODS The predictive value of biological and clinical events occurring during the 24 months prior to the occurrence of CD4 threshold (n = 333) was quantified in a Cox model. Another Cox model was carried out in a subset of 77 patients in whom viral load from stored sera was available. Furthermore, changes in viral load during the 24 months preceding the CD4 threshold were assessed in a mixed model according to subsequent development of AIDS. RESULTS Among the 333 patients, the slope of the CD4+ cell counts, the emergence of p24 antigen, persistent thrush, and age at the CD4 threshold were independent predictors of progression to clinical AIDS (44.7%). Among the subset of 77 patients, the HIV-1 RNA level at the CD4 threshold, persistent thrush and age remained independent predictors of progression to AIDS (45.5%). The increase of the HIV-1 RNA level was moderate, both in non-progressors (24.0% per year) and in those who subsequently developed AIDS (27.1% per year), (P = 0.93). Viral load was consistently higher in the latter group (P = 0.002). CONCLUSION At a late stage of infection, age and persistent thrush remain predictive of progression to AIDS, independently of viral load.
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Affiliation(s)
- N Carré
- INSERM U292, Secteur Bleu Pierre-Marié Porte 26, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
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Girma JP, Fressinaud E, Houllier A, Laurian Y, Amiral J, Meyer D. Assay of factor VIII antigen (VIII:CAg) in 294 haemophilia A patients by a new commercial ELISA using monoclonal antibodies. Haemophilia 1998; 4:98-103. [PMID: 9873846 DOI: 10.1046/j.1365-2516.1998.00149.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [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: 11/20/2022]
Abstract
Monoclonal antibodies (MoAbs 833 and D4H1) directed against human factor VIII (FVIII) have been produced on a large scale to measure VIII:CAg by two-site ELISA (Asserachrom VIII:CAg, Diagnostica Stago). F(ab')2 from MoAb 833 were used for coating and bound VIII:CAg was revealed with MoAb D4H1 coupled to peroxidase. Control plasma (100 VIII:CAg U dL-1 by comparing with the International Standard) was used as reference. The assay sensitivity was 0.1 U dL-1 VIII:CAg. No apparent effect of the plasma proteins was observed provided plasma dilution was > or = 5. Thus this ELISA allowed us to estimate VIII:CAg levels of 0.5 U dL-1 in plasma. Levels of VIII:CAg were similar to those of VIII:C (correlation coefficient r = 0.87) in plasma from normal individuals (32 cases) and in patients with von Willebrand disease of various types (30 cases). Among 294 patients with haemophilia A (HA), 161 had severe HA (VIII:C < 1 U dL-1). Among those patients, 124 were cross-reacting material (CRM) negative with undetectable VIII:CAg and 37 were CRM+ (VIII:CAg 1-31 U dL-1). In 42 patients with moderate HA (VIII:C 1-5 U dL-1), 33 were CRM reduced (VIII:CAg 0.5-8 U dL-1) and nine were CRM+ with a VIII:CAg/VIII:C ratio of 6-91 (mean 34.3). In mild HA (91 cases with VIII:C > or = 6 U dL-1), 29 patients were classified as CRM+ (VIII:C 6-57 U dL-1, VIII:CAg 17-130 U dL-1 and VIII:CAg/VIII:C ratio 1.8-13.7 (mean 4.51)). In 62 CRM reduced patients there was a linear correlation between VIII:C (6-39 U dL-1) and VIII:CAg (2-36 U dL-1) levels (r = 0.88). In conclusion, this sensitive assay allows us to distinguish the quantitative CRM reduced and negative from the qualitative (CRM+) abnormalities in haemophilia A.
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Affiliation(s)
- J P Girma
- INSERM U.143, Hôpital de Bicêtre, Paris.
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Abstract
We report two patients with severe haemophilia A, factor VIII < 2 u dL-1, diagnosed at birth, through isolated bleeding in the adrenal gland (case 1) and through a haematoma in the liver (case 2). In these two clinical cases, the vital emergency, with haemorrhagic shock, required early diagnosis of the hereditary coagulation defect. Generally at birth, any unexplained bleeding should prompt screening for haemophilia. In the newborn period, the PTT is inadequate for many reasons and the laboratory evaluation must include factor VIII and IX levels.
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Affiliation(s)
- C Le Pommelet
- Unité de Soins Intensifs Pédiatriques, Hôpital Bicêtre, Le Kremlin- Bicêtre, France
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Gautreau C, Gazengel C, Sultan Y, Laurian Y, Costagliola D. Progression to AIDS in french haemophiliacs: Analysis of the association with HLA DR1 and DR5. Hum Immunol 1996. [DOI: 10.1016/0198-8859(96)85347-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hay C, Laurian Y. Induction of Tolerance
Using Porcine Factor VIII. Vox Sang 1996. [DOI: 10.1159/000462146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Buffet C, Laurent-Puig P, Chandot S, Laurian Y, Charpentier B, Briantais MJ, Dussaix E. A high hepatitis E virus seroprevalence among renal transplantation and haemophilia patient populations. J Hepatol 1996; 24:122-5. [PMID: 8834035 DOI: 10.1016/s0168-8278(96)80196-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Antonarakis SE, Rossiter JP, Young M, Horst J, de Moerloose P, Sommer SS, Ketterling RP, Kazazian HH, Négrier C, Vinciguerra C, Gitschier J, Goossens M, Girodon E, Ghanem N, Plassa F, Lavergne JM, Vidaud M, Costa JM, Laurian Y, Lin SW, Lin SR, Shen MC, Lillicrap D, Taylor SA, Windsor S, Valleix SV, Nafa K, Sultan Y, Delpech M, Vnencak-Jones CL, Phillips JA, Ljung RC, Koumbarelis E, Gialeraki A, Mandalaki T, Jenkins PV, Collins PW, Pasi KJ, Goodeve A, Peake I, Preston FE, Schwartz M, Scheibel E, Ingerslev J, Cooper DN, Millar DS, Kakkar VV, Giannelli F, Naylor JA, Tizzano EF, Baiget M, Domenech M, Altisent C, Tusell J, Beneyto M, Lorenzo JI, Gaucher C, Mazurier C, Peerlinck K, Matthijs G, Cassiman JJ, Vermylen J, Mori PG, Acquila M, Caprino D, Inaba H. Factor VIII gene inversions in severe hemophilia A: results of an international consortium study. Blood 1995; 86:2206-12. [PMID: 7662970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Twenty-two molecular diagnostic laboratories from 14 countries participated in a consortium study to estimate the impact of Factor VIII gene inversions in severe hemophilia A. A total of 2,093 patients with severe hemophilia A were studied; of those, 740 (35%) had a type 1 (distal) factor VIII inversion, and 140 (7%) showed a type 2 (proximal) inversion. In 25 cases, the molecular analysis showed additional abnormal or polymorphic patterns. Ninety-eight percent of 532 mothers of patients with inversions were carriers of the abnormal factor VIII gene; when only mothers of nonfamilial cases were studied, 9 de novo inversions in maternal germ cells were observed among 225 cases (approximately 1 de novo maternal origin of the inversion in 25 mothers of sporadic cases). When the maternal grandparental origin was examined, the inversions occurred de novo in male germ cells in 69 cases and female germ cells in 1 case. The presence of factor VIII inversions is not a major predisposing factor for the development of factor VIII inhibitors; however, slightly more patients with severe hemophilia A and factor VIII inversions develop inhibitors (130 of 642 [20%]) than patients with severe hemophilia A without inversions (131 of 821 [16%]).
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Guérois C, Laurian Y, Rothschild C, Parquet-Gernez A, Duclos AM, Négrier C, Vicariot M, Fimbel B, Fressinaud E, Fiks-Sigaud M. Incidence of factor VIII inhibitor development in severe hemophilia A patients treated only with one brand of highly purified plasma-derived concentrate. Thromb Haemost 1995; 73:215-8. [PMID: 7792732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The incidence of factor VIII inhibitor was studied in a cohort of 56 previously untreated patients with severe hemophilia A (factor VIII below 1 U/dl). They received only one brand of highly purified factor VIII concentrate (HPSD-VIII) prepared by conventional chromatography with a solvent-detergent step for viral inactivation. Follow-up since the first infusion of HPSD-VIII was from 1 to 76 months (mean = 29) and cumulative exposure days (CED) from 1 to over 100 (median = 26). Five patients (9%) developed an inhibitor after 6 to 19 CED, only one being a high responder (2%), showing a low incidence of inhibitor compared with previous studies using high purity plasma-derived or recombinant products.
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Kriaa F, Laurian Y, Hiesse C, Tchernia G, Charpentier B. Five year experience with protein A immunoadsorption in patients with allo/auto-antibodies (anti-HLA antibodies, autoimmune bleeding disorders) and transplant patients with relapsing focal glomerular sclerosis. Transplant Proc 1995; 27:1031-2. [PMID: 7878790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- F Kriaa
- Service de Néphrologie CHU de Bicêtre, France
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Kriaa F, Laurian Y, Hiesse C, Tchernia G, Charpentier B. Five years' experience at one centre with protein A immunoadsorption in patients with deleterious allo/autoantibodies (anti-HLA antibodies, autoimmune bleeding disorders) and post-transplant patients relapsing with focal glomerular sclerosis. Nephrol Dial Transplant 1995; 10 Suppl 6:108-10. [PMID: 8524477 DOI: 10.1093/ndt/10.supp6.108] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [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: 01/31/2023] Open
Abstract
Protein A is extracted from a strain of Staphylococcus aureus and binds specifically to the constant domains of immunoglobulins and possibly to fibronectin. It has already been shown that concentrations of all IgG isotypes (except IgG3) are efficiently decreased by immunoadsorption (IA) on protein A linked to sepharose beads. This system has been developed by Cobe-Excorim Co. to either remove IgG in some instances where they wil be harmful, i.e. allo- and autoantibodies inducing pathological conditions (autoimmune diseases, haematological disorders with allo/autoantibodies, anti-HLA antibodies in sensitized patients awaiting organ transplantation) or treat several immunological diseases with unknown pathogenesis. In our unit, 20 patients with high titres of anti-HLA panel-reactive antibodies, four patients with haematological disorders (haemophilia with anti-VIII antibodies and Glanzmann diseases) and three patients with post-transplant focal glomerular sclerosis (FGS) underwent IA over the past 5 years. Infectious complications were not observed after IA and the procedure was always well tolerated. In spite of the use of adjunctive immunosuppressive therapy with prednisone and cyclophosphamide, and although the reduction in serum IgG was close to 90%, the de novo synthesis of allo- and autoantibodies was important after IA procedures. In the cases of removal of anti-HLA antibodies, patients with a pre-IA antibody titre which was > 1:128 clearly did not benefit from the technique and other immunological criteria were not predictive of efficacy. Fourteen patients were transplanted, four with a well-matched kidney with both pre- and post-IA negative cross-matching, and 10 with a positive historical cross-match with the donor.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- F Kriaa
- Service de Néphrologie, CHU de Bicêtre, Kremlin Bicêtre, France
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Stieltjes N, Sultan Y, Rothschild C, Torchet MF, Laurian Y, Navarro R, Fressinaud E, Gernez AP, Fonlupt J, Berthier AM. Long-term survival of HIV-infected patients with haemophilia. Haemophilia 1995; 1:33-6. [DOI: 10.1111/j.1365-2516.1995.tb00037.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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47
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Laurian Y, Dussaix E, Parquet A, Chalvon-Demersay A, d'Oiron R, Tchernia G. Transmission of human parvovirus B19 by plasma derived factor VIII concentrates. Nouv Rev Fr Hematol (1978) 1994; 36:449-53. [PMID: 7753615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Although clotting factor concentrates prepared from large pools of plasma are considered to be safe for enveloped viruses (HIV, HBV and HCV), these products are likely to remain at risk for non lipid enveloped viruses. The prevalence of positive IgG serology for human parvovirus B19 (HPV-B19) was determined in 53 children suffering from haemophilia A, who had been treated from birth with only one brand of a highly purified factor VIII concentrate prepared by ion exchange chromatography with a solvent-detergent step (HPSD-VIII). HPV-B19 seropositivity ranged from 20 to 43% in 198 age matched controls. In contrast, the incidence of positive HPV-B19 IgG serology varied from 75 to 100% in haemophiliacs and all 10 severe haemophilia A patients under 3 years of age were seropositive. The presence of HPV-B19 in this clotting factor concentrate demonstrates that at least a proportion of such products continue to transmit non lipid enveloped viruses.
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Affiliation(s)
- Y Laurian
- Centre de Traitement pour Hémophiles, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
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Laurian Y, Lusher JM, Kessler CM. Viral safety and clotting factor concentrates. Thromb Haemost 1994; 72:649. [PMID: 7878650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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49
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Dussaix E, Charnaux N, Laurent-Puig P, Chopineau S, Laurian Y, Buffet C. Analysis of sera indeterminate by Ortho-HCV RIBA-2 by using three confirmatory assays for anti-hepatitis C virus antibody. J Clin Microbiol 1994; 32:2071-5. [PMID: 7529247 PMCID: PMC263944 DOI: 10.1128/jcm.32.9.2071-2075.1994] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [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: 01/25/2023] Open
Abstract
The diagnostic performances of three commercially available recombinant immunoblot assays (RIBAs) for anti-hepatitis C virus antibody were evaluated on 50 ORTHO-HCV RIBA-2 (RIBA-2)-indeterminate serum samples. Concordant interpretations were obtained with the three tests in 60% of the samples, with 56% positive, 2% indeterminate, and 2% negative results. Considering test performance in regard to the number of remaining indeterminate results, analyzing sera by RIBA-3, INNO-LIA HCV Ab III, and DECISCAN HCV reduced the number of samples reacting indeterminately to 40, 6, and 8%, respectively. The three serum samples classified as indeterminate in the INNO-LIA HCV Ab III as well as three of four serum samples interpreted as indeterminate in the DECISCAN HCV and 16 of 20 samples classified as indeterminate in the RIBA-3 were hepatitis C virus RNA positive by PCR. This study clearly shows the good performance of the three tests as confirmatory assays compared with that of the RIBA-2. However, according to the manufacturers' criteria of positivity, the INNO-LIA HCV Ab III and DECISCAN HCV appeared to be more suitable than the RIBA-3 for interpreting serum samples found indeterminate in the RIBA-2.
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Affiliation(s)
- E Dussaix
- Department of Virology, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
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50
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Lusher J, Kessler C, Laurian Y, Pierce G. Viral contamination of blood products. Lancet 1994; 344:405-6. [PMID: 7914325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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