The Platelet Function Analyser (<scp>PFA</scp>)‐100 and von Willebrand disease: a story well over 16 years in the making

Favaloro, Emmanuel J.

doi:10.1111/hae.12710

Cited by 23 publications

(27 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These VWF‐dependent platelet function analyses are performed without additional technical manipulation, and PFA enables the measurement of the impact of high shear stress blood. In our study, prolonged CT with PFA was detected in all VWD types, supporting the inclusion of platelet contribution and the use of this assay, among conflicting previous reports . These tests can add value as screening tools and provide support for challenging diagnostics.…”

Section: Discussionsupporting

confidence: 86%

“…No blood flow and shear force‐based clinical assays are in routine use. The role of the platelet function analyzer PFA‐100 ® (PFA), a primary hemostasis screening tool under high shear stress, is under debate . Multiplate ® (Multiplate) is a next‐generation automated whole blood aggregometry device that does not require additional technical manipulation .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comprehensive re‐evaluation of historical von Willebrand disease diagnosis in association with whole blood platelet aggregation and function

Nummi

Lassila

Joutsi‐Korhonen

et al. 2018

Int J Lab Hematology

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Comprehensive re‐evaluation of historical von Willebrand disease diagnosis in association with whole blood platelet aggregation and function

Nummi

Lassila

Joutsi‐Korhonen

et al. 2018

Int J Lab Hematology

View full text Add to dashboard Cite

show abstract

“…For As far as the diagnosis of VWD is concerned, the PFA100 undoubtedly performs excellently. 20,28,29 P < .001, Figure 3). Interestingly, patients with more than one bleeding episode showed a considerably shortened overall survival too.…”

Section: Discussionmentioning

confidence: 93%

Disease progression and defects in primary hemostasis as major cause of bleeding in multiple myeloma

Hinterleitner

Pecher

Kreißelmeier

et al. 2019

European J of Haematology

View full text Add to dashboard Cite

Background and objectives In patients with multiple myeloma (MM), unexpected bleeding complications remain a major issue. Since routine coagulation parameters are often inconspicuous, diagnosis and treatment of the underlying coagulation disorders are challenging. Patients and methods In our single‐center observational study, we analyzed 164 patients with MM for coagulation disorders and bleeding complications. Results Prolonged closure times (CTs), measured by PFA‐100, were the most common, abnormal coagulation test, found in 66% of bleeding patients vs 5% in non‐bleeding, followed by qualitative defects of von Willebrand factor (VWF:CB/VWF:Ag ratios), found in 34% vs 1% in the non‐bleeding group. Increased serum free light chains (SFLC) and SFLC ratios were significantly associated with prolonged CTs and acquired von Willebrand syndrome (AVWS). Prolonged CTs and AVWS were associated with disease progression, determined by dynamics of SFLC ratios (P < .001), serum creatinine level (P = .013), Beta‐2 microglobulin (P = .03), LDH (P = .016), and bone marrow infiltration (P < .001). Of note, response to myeloma therapy was frequently correlated with normalization of coagulation parameters. Conclusions Bleeding complications in MM are predominantly caused by defects in primary hemostasis and associated with disease progression. In a peri‐interventional workup, determination of CTs and VWF:CB/VWF:Ag ratios are of significant importance to assess bleeding risk.

show abstract

“…Sometimes clinicians will order a PFA‐100/200 to “screen” for a “bleeding disorder” (in particular a platelet dysfunction or VWD). Although the PFA‐100/200 is very sensitive to severe platelet dysfunction or VWD, it may provide normal test results with milder disorders . Thus, although normal PFA‐100/200 results will generally exclude “severe” platelet dysfunction or VWD, they will not exclude “mild” platelet dysfunction or VWD.…”

Section: Initial Limited Clinical Requests As An Important Consideratmentioning

confidence: 99%

“…Although the PFA-100/200 is very sensitive to severe platelet dysfunction or VWD, it may provide normal test results with milder disorders. [54][55][56] Thus, although normal PFA-100/200 results will generally exclude "severe" platelet dysfunction or VWD, they will not exclude "mild" test results is provided in Figure 3. Potential guidance in the form of sample postanalytical comments is also provided in Table 1.…”

Section: Platelet Function Analyser (Pfa)-100/200 Ordered For Invesmentioning

confidence: 99%

Postanalytical considerations that may improve the diagnosis or exclusion of haemophilia and von Willebrand disease

2018

View full text Add to dashboard Cite

von Willebrand disease (VWD) and haemophilia represent the most common inherited or acquired bleeding disorders. However, many laboratories and clinicians may be challenged by their accurate diagnosis or exclusion. Difficulties in diagnosis/exclusion may include analytical issues, where assays occasionally generate an incorrect result (ie representing an analytical error) or have limitations in their measurement range of and/or low analytical sensitivity. Also increasingly recognized is the influence of preanalytical issues on the diagnosis of VWD or haemophilia. Unfortunately, postanalytical considerations are often not well considered in the diagnostic process. Therefore, this narrative review aims to provide an overview of some important postanalytical considerations that may help improve the diagnosis of VWD and haemophilia. This review primarily discusses aspects around reporting of test results. However, we also discuss other less well-recognized postanalytical considerations, including the use of assay ratios to help identify differential diagnoses and then guide further investigation.

show abstract

The Platelet Function Analyser (PFA)‐100 and von Willebrand disease: a story well over 16 years in the making

Cited by 23 publications

References 19 publications

Comprehensive re‐evaluation of historical von Willebrand disease diagnosis in association with whole blood platelet aggregation and function

Comprehensive re‐evaluation of historical von Willebrand disease diagnosis in association with whole blood platelet aggregation and function

Disease progression and defects in primary hemostasis as major cause of bleeding in multiple myeloma

Postanalytical considerations that may improve the diagnosis or exclusion of haemophilia and von Willebrand disease

Contact Info

Product

Resources

About