Feasibility of using thrombin generation assay (TGA) for monitoring of haemostasis during supplementation therapy in haemophilic patients without inhibitors

被引:18
作者
Ay, Y. [1 ]
Balkan, C. [1 ]
Karapinar, D. Y. [1 ]
Akin, M. [1 ]
Bilenoglu, B. [1 ]
Kavakli, K. [1 ]
机构
[1] Ege Univ, Dept Hematol, Childrens Hosp, Ege Hemophilia Ctr,Med Sch, TR-35100 Izmir, Turkey
关键词
haemophilia; thrombin generation assay; thromboelastography;
D O I
10.1111/j.1365-2516.2012.02849.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Monitoring factor replacement treatment and observing concordance with clinical haemostasis is crucial in vital haemorrhages and major surgeries in haemophilic patients. We aimed to investigate the value of the thrombin generation assay (TGA) and thromboelastography (TEG) for monitoring haemostasis in haemophilic patients during factor replacement treatment. The study group consisted of 29 patients (21 haemophilia A, 8 haemophilia B). All the patients FVIII-inhibitor were negative. A total of 35 bleeding episodes and/or surgical interventions were evaluated. aPTT, FVIII/FIX activity, TEG and TGA tests were conducted before and after factor therapy during the bleeding episode or surgical prophylaxis of haemophilic patients. Correlations among these tests were evaluated and compared with clinical responses. No correlation was found among aPTT, factor activities and clinical outcome. There were also no correlation found between TEG parameters and clinical outcome. The only significant correlation found between TGA parameters and clinical outcome was the correlation between peak thrombin. In conclusion, we found superiority of TGA-peak thrombin over other traditional tests for monitoring haemostasis in haemophilic patients in this study.
引用
收藏
页码:911 / 916
页数:6
相关论文
共 29 条
[11]  
Sorensen B., Ingerslev J., Whole blood clot formation phenotypes in haemophilia A and rare coagulation disorders, J Thromb Haemost, pp. 102-10, (2004)
[12]  
Dargaud Y., Luddington R., Baglin T., Platelet dependent thrombography: a method for diagnostic laboratories, B J Haematol, 134, pp. 323-5, (2006)
[13]  
Dargaud Y., Bordet J.C., Francillon S., Negrier C., Haemophilia patients exhibit prolonged coagulation time but normal lag time of thrombin generation test: are these results really discordant, Thromb Haemost, 97, pp. 675-6, (2007)
[14]  
Van Veen J.J., Gatt A., Makris M., Thrombin generation testing in routine clinical practice: are we there yet?, Br J Haematol, 142, pp. 889-903, (2008)
[15]  
Luddington R., Baglin T., Clinical measurement of thrombin generation by calibrated automated thrombography requires contact factor inhibition, J Thromb Haemost, 2, pp. 1954-9, (2004)
[16]  
Chantarangkul V., Clerici M., Bressi C., Et al., Thrombin generation assessed as endogenous thrombin potential in patients with hyper- or hypo-coagulability, Haematologica, 88, pp. 547-54, (2003)
[17]  
McIntosh J.H., Owens D., Lee C.A., Et al., A modified thrombin generation test for the measurement of factor VIII concentrates, J Thromb Haemost, 1, pp. 1005-11, (2003)
[18]  
Salvagno G.L., Astermark J., Lippi G., Et al., Thrombin generation assay: a useful routine check -up tool in the management of patients with haemophilia?, Haemophilia, 15, pp. 290-6, (2009)
[19]  
Lewis S.J., Stephens E., Florou G., Et al., Measurement of global haemostasis in severe haemophilia A following factor VIII infusion, Br J Haematol, 138, pp. 775-82, (2007)
[20]  
Hemker H.C., Beguin S., Thrombin generation in plasma: its assessment via the endogenous thrombin potential, Thromb Haemost, 74, pp. 134-8, (1995)