학술논문

Evaluation of the utility of the ISTH- BAT in haemophilia carriers: a multinational study.
Document Type
Article
Source
Haemophilia. Nov2016, Vol. 22 Issue 6, p912-918. 7p. 1 Diagram, 3 Charts, 1 Graph.
Subject
*HEMOPHILIA
*HEMARTHROSIS
*HEMORRHAGE
*BLOOD coagulation factor VIII
*BLOOD coagulation factor IX
*PATHOLOGICAL physiology
Language
ISSN
1351-8216
Abstract
Introduction There has been increasing recognition in recent years that female carriers of haemophilia manifest abnormal bleeding; however, data on the use of bleeding assessment tools in this population are lacking. Aim Our objective was to validate the ISTH- BAT in haemophilia carriers to describe bleeding symptoms and allow for comparisons with factor levels and other patient groups. Methods This was a prospective, observational, cross-sectional study performed by members of Global Emerging HEmostasis Panel ( GEHEP). Unselected consecutive haemophilia carriers were recruited and a CRF and the ISTH- BAT were completed by study personnel. Results A total of 168 haemophilia carriers were enrolled: 155 haemophilia A and 13 haemophilia B. The mean age was 40 years (range: 20-82). Carriers had higher mean bleeding scores ( BS) compared with age-matched controls ( n = 46; 5.7 vs. 1.43; P < 0.0001) and Type 3 VWD OC ( n = 32; 3.0; P = 0.009), but lower BS compared with women with Type 1 VWD ( n = 83; 8.7; P < 0.0001). Fifteen carriers reported haemarthrosis, and of those six had normal FVIII/ FIX levels. There was a significant but weak negative correlation between BS and factor level (Spearman's r2 = −0.36, P < 0.001). Conclusion Our results show that haemophilia carriers experience abnormal bleeding, including haemarthrosis. Overall, BS in women with Type 1 VWD > haemophilia carriers > Type 3 VWD OC > controls. Understanding the performance of the ISTH- BAT in this population is a critical step in future research aimed at investigating the underlying pathophysiology of abnormal bleeding, with the ultimate goal of optimizing treatment. [ABSTRACT FROM AUTHOR]