THROMBIN GENERATION AND WHOLE BLOOD VISCOELASTIC ASSAYS IN THE MONITORING OF HAEMOPHILIA WITH INHIBITORS
(Abstract release date: 05/19/16)
EHA Library. Serban M. 06/09/16; 132540; E991
Prof. Dr. Margit Serban
Contributions
Contributions
Abstract
Abstract: E991
Type: Eposter Presentation
Background
During the past decade numerous studies using thrombin generation (TGA) and viscoelastic tests (TEG) have been introduced in clinical laboratories, looking for a new perspective on monitoring patients with severe haemophilia complicated with inhibitors.
Aims
We attempted to obtain a more reliable image on global hemostasis of patients with haemophilia A (HA) and high titre inhibitors treated with bypassing agents (BPAs) by using these two new laboratory tools, TGA and TEG.
Methods
Seven persons with HA and high titre inhibitors treated with by passing agents during 12 bleeding episodes, 5 of them in invasive surgical conditions have been evaluated. Reaction time (R), kynetics (K) and maximal amplitude (MA) on thrombelastograph System 5000, and lag time, peak, time to peak (ttpeak), endogenous thrombin potential (ETP), start tail and velocity index have been the focused parameters, interpreted also in connection with the clinical outcomes. The same procedure was performed on 15 healthy volunteer control group.
Results
While traditional coagulometric assay failed giving information on the global hemostatic potential, TEG displayed significantly prolonged R and K (p<0.01), with prompt improvement after BPAs administration. The thrombogram revealed also significantly low values (p<0.001) for peak and velocity index and prolonged time to peak and start tail, also, with significant (p<0.01) long lasting (more than 4 hours) improvement after BPAs administration.
Conclusion
In our modest experience, the combined use of TEG and TGA has been a useful source for surrogate markers, able providing more informative and reliable data on the impact of BPAs on the hemostatic results in an attempt of a more safe and effective personalised therapy in haemophilia complicated with inhibitors.
Session topic: E-poster
Keyword(s): Hemophilia A, Inhibitor, Thrombelastograph, Thrombin generation
Type: Eposter Presentation
Background
During the past decade numerous studies using thrombin generation (TGA) and viscoelastic tests (TEG) have been introduced in clinical laboratories, looking for a new perspective on monitoring patients with severe haemophilia complicated with inhibitors.
Aims
We attempted to obtain a more reliable image on global hemostasis of patients with haemophilia A (HA) and high titre inhibitors treated with bypassing agents (BPAs) by using these two new laboratory tools, TGA and TEG.
Methods
Seven persons with HA and high titre inhibitors treated with by passing agents during 12 bleeding episodes, 5 of them in invasive surgical conditions have been evaluated. Reaction time (R), kynetics (K) and maximal amplitude (MA) on thrombelastograph System 5000, and lag time, peak, time to peak (ttpeak), endogenous thrombin potential (ETP), start tail and velocity index have been the focused parameters, interpreted also in connection with the clinical outcomes. The same procedure was performed on 15 healthy volunteer control group.
Results
While traditional coagulometric assay failed giving information on the global hemostatic potential, TEG displayed significantly prolonged R and K (p<0.01), with prompt improvement after BPAs administration. The thrombogram revealed also significantly low values (p<0.001) for peak and velocity index and prolonged time to peak and start tail, also, with significant (p<0.01) long lasting (more than 4 hours) improvement after BPAs administration.
Conclusion
In our modest experience, the combined use of TEG and TGA has been a useful source for surrogate markers, able providing more informative and reliable data on the impact of BPAs on the hemostatic results in an attempt of a more safe and effective personalised therapy in haemophilia complicated with inhibitors.
Session topic: E-poster
Keyword(s): Hemophilia A, Inhibitor, Thrombelastograph, Thrombin generation
Abstract: E991
Type: Eposter Presentation
Background
During the past decade numerous studies using thrombin generation (TGA) and viscoelastic tests (TEG) have been introduced in clinical laboratories, looking for a new perspective on monitoring patients with severe haemophilia complicated with inhibitors.
Aims
We attempted to obtain a more reliable image on global hemostasis of patients with haemophilia A (HA) and high titre inhibitors treated with bypassing agents (BPAs) by using these two new laboratory tools, TGA and TEG.
Methods
Seven persons with HA and high titre inhibitors treated with by passing agents during 12 bleeding episodes, 5 of them in invasive surgical conditions have been evaluated. Reaction time (R), kynetics (K) and maximal amplitude (MA) on thrombelastograph System 5000, and lag time, peak, time to peak (ttpeak), endogenous thrombin potential (ETP), start tail and velocity index have been the focused parameters, interpreted also in connection with the clinical outcomes. The same procedure was performed on 15 healthy volunteer control group.
Results
While traditional coagulometric assay failed giving information on the global hemostatic potential, TEG displayed significantly prolonged R and K (p<0.01), with prompt improvement after BPAs administration. The thrombogram revealed also significantly low values (p<0.001) for peak and velocity index and prolonged time to peak and start tail, also, with significant (p<0.01) long lasting (more than 4 hours) improvement after BPAs administration.
Conclusion
In our modest experience, the combined use of TEG and TGA has been a useful source for surrogate markers, able providing more informative and reliable data on the impact of BPAs on the hemostatic results in an attempt of a more safe and effective personalised therapy in haemophilia complicated with inhibitors.
Session topic: E-poster
Keyword(s): Hemophilia A, Inhibitor, Thrombelastograph, Thrombin generation
Type: Eposter Presentation
Background
During the past decade numerous studies using thrombin generation (TGA) and viscoelastic tests (TEG) have been introduced in clinical laboratories, looking for a new perspective on monitoring patients with severe haemophilia complicated with inhibitors.
Aims
We attempted to obtain a more reliable image on global hemostasis of patients with haemophilia A (HA) and high titre inhibitors treated with bypassing agents (BPAs) by using these two new laboratory tools, TGA and TEG.
Methods
Seven persons with HA and high titre inhibitors treated with by passing agents during 12 bleeding episodes, 5 of them in invasive surgical conditions have been evaluated. Reaction time (R), kynetics (K) and maximal amplitude (MA) on thrombelastograph System 5000, and lag time, peak, time to peak (ttpeak), endogenous thrombin potential (ETP), start tail and velocity index have been the focused parameters, interpreted also in connection with the clinical outcomes. The same procedure was performed on 15 healthy volunteer control group.
Results
While traditional coagulometric assay failed giving information on the global hemostatic potential, TEG displayed significantly prolonged R and K (p<0.01), with prompt improvement after BPAs administration. The thrombogram revealed also significantly low values (p<0.001) for peak and velocity index and prolonged time to peak and start tail, also, with significant (p<0.01) long lasting (more than 4 hours) improvement after BPAs administration.
Conclusion
In our modest experience, the combined use of TEG and TGA has been a useful source for surrogate markers, able providing more informative and reliable data on the impact of BPAs on the hemostatic results in an attempt of a more safe and effective personalised therapy in haemophilia complicated with inhibitors.
Session topic: E-poster
Keyword(s): Hemophilia A, Inhibitor, Thrombelastograph, Thrombin generation
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