Use of heat‐treated clotting‐factor concentrates in patients with haemophilia and a high exposure to HTLV‐III

Km, McGrath; Kb, Thomas; Rw, Herrington; Pj, Turner; Taylor, L.; Ekert, H.; Schiff, P; Id, Gust

doi:10.5694/j.1326-5377.1985.tb122758.x

Cited by 15 publications

(2 citation statements)

References 15 publications

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“…This study presents the clinical and laboratory features of HTLV-I11 infection in a group of hemophiliacs who were treated at a single center with clotting factor concentrates prepared by one manufacturer using plasma obtained from Australian volunteer blood donors. The earliest infection occurred in 1981; however, most patients were infected during 1983 and 1984 [2], 6-24 months prior to the study. The number of seropositive patients with overt clinical abnormalities (28 %) was only slightly less than the 39% reported from the Newcastle Hemophilia Reference Centre (UK) [3] ; however, the proportion of patients with significant physical incapacity was very low (5%), and only one patient has so far developed AIDS.…”

Section: Discussionmentioning

confidence: 99%

“…HTLV-I11 antibody has been detected in 74% of hemophilia A and 39% of hemophilia B patients in the U.S. [ 11. A recent report from this hospital demonstrated a similar prevalence in patients with severe disease receiving concentrates prepared solely from Australian plasma [2]. Clinical features of HTLV-111 infection have also been described [3] in hemophiliacs, including acquired immune deficiency syndrome (AIDS), lymphadenopathy syndrome, and immune thrombocytopenia; however, the frequency of significant symptomatology has not been well established.…”

Section: Introductionmentioning

confidence: 87%

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Spectrum of HTLV‐III infection in a hemophilic cohort treated with blood products from a single manufacturer

McGrath

Spelman²,

Barnett

et al. 1986

American J Hematol

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One hundred fifty-eight hemophilia A, B, and von Willebrand disease (VWD) patients treated with clotting factor concentrates from a single manufacturer were tested for antibody to the human T-lymphotropic virus type III (HTLV-III). Antibody was detected in 63% and 40% of those with severe hemophilia A and B, respectively, 12% and 0% of those with mild hemophilia A and B, and two patients with recessive VWD. Forty-two antibody-positive and 20 antibody-negative patients were studied for clinical and laboratory features of infection. Eleven seropositive patients had clinical signs of infection including Pneumocystis carinii pneumonia, lymphadenopathy, splenomegaly or diarrhea; however, only one patient had developed acquired immune deficiency syndrome (AIDS), and only two had significant impairment of their performance status. Thirty-one patients remained totally asymptomatic. Eight patients had a history suggestive of acute HTLV-III infection. Thrombocytopenia was observed in 18% of seropositive patients, lymphopenia in 60%, depressed T-helper cells in 43%, reduced T-helper:T-suppressor ratios (TH:TS) in 33%, and elevated platelet-bound immunoglobulin in 53%. The antibody-negative group had normal T-helper cell levels (except one patient) and TH:TS ratios, and normal platelet immunoglobulin levels. Both groups demonstrated a significant elevation of immunoglobulin levels and a high prevalence of antinuclear factor and antismooth muscle antibodies. The mean level of IgG was significantly higher in the antibody-positive group. This study confirms the correlation between HTLV-III infection and reduced T-helper cells in hemophiliacs but demonstrates a low incidence of clinical symptomatology. There was evidence of polyclonal B-cell hyperactivity in the antibody-negative group as well as the seropositive group.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 87%

Spectrum of HTLV‐III infection in a hemophilic cohort treated with blood products from a single manufacturer

McGrath

Spelman²,

Barnett

et al. 1986

American J Hematol

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Pharmakokinetische Untersuchungen an Hämophilie B-Patienten nach Infusion eines Faktor IX-Konzentrates

Seifried

Köhler

Pindur

et al. 1988

18. Hämophilie-Symposion Hamburg 1987

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In vivo recovery and half-life time of a steam-treated factor IX concentrate in hemophilia B patients

Köhler

Seifried

Hellstern

et al. 1988

Blut

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Factor IX (FIX) recovery and half-life was measured in ten hemophilia B patients under standardized conditions. Each patient received a steam-treated high-purity factor IX concentrate at a dose of 19-39 U/kg body weight. FIX activity was determined using a one-stage assay, which was calibrated against the international concentrate standard (reagents from Immuno, Heidelberg). The in vivo recovery ranged from 24% to 53% (mean value 37.7%) and the half-disappearance time (HDT) from 8-30 h (mean 16.7 h). In four of the ten patients, the distribution and elimination half-lives were estimated and ranged from 0.3 h to 3.9 h (mean 1.4 h) and from 28.6 h to 39.7 h (mean 33.1 h), respectively. In six patients FIX was redetermined using a different FIX deficient plasma and a plasma standard (reagents from Merz & Dade, Munich, FRG). Recoveries and HDT based on the results obtained with this method were significantly higher (68.2% vs 39.7%; p less than 0.05), and longer (14.8 h vs 10.6 h; p less than 0.05), respectively. FIX activity was also measured by both assay systems in 100 healthy subjects (50 males, 50 females). The reagents from Immuno yielded a mean value of 0.77 U/ml, while the mean FIX activity utilizing standards and reagents from Merz & Dade was 1.11 U/ml (p less than 0.000001). The coefficient of correlation between the FIX activity measurements, as determined in 100 healthy subjects and 6 hemophilia B patients using the different test systems, was r = 0.9 (N = 159; y = 0.08 +/- 1.3* chi; p less than 0.001). Our data suggest that recovery and HDT of factor IX concentrate strongly depend on the assay and calibration conditions and that an international FIX activity plasma standard is urgently required.

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Use of heat‐treated clotting‐factor concentrates in patients with haemophilia and a high exposure to HTLV‐III

Cited by 15 publications

References 15 publications

Spectrum of HTLV‐III infection in a hemophilic cohort treated with blood products from a single manufacturer

Spectrum of HTLV‐III infection in a hemophilic cohort treated with blood products from a single manufacturer

Pharmakokinetische Untersuchungen an Hämophilie B-Patienten nach Infusion eines Faktor IX-Konzentrates

In vivo recovery and half-life time of a steam-treated factor IX concentrate in hemophilia B patients

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