Journal article
Characterization of the anti-factor VIII immunoglobulin profile in patients with hemophilia A by use of a fluorescence-based immunoassay
Journal of thrombosis and haemostasis, Vol.13(1), pp.47-53
01/2015
DOI: 10.1111/jth.12768
PMCID: PMC4383171
PMID: 25354263
Abstract
Background
The development of neutralizing antibodies, referred to as inhibitors, against factor VIII is a major complication associated with FVIII infusion therapy for the treatment of hemophilia A (HA). Previous studies have shown that a subset of HA patients and a low percentage of healthy individuals harbor non-neutralizing anti-FVIII antibodies that do not elicit the clinical manifestations associated with inhibitor development.
Objective
To assess HA patients' anti-FVIII antibody profiles as potential predictors of clinical outcomes.
Methods
A fluorescence immunoassay (FLI) was used to detect anti-FVIII antibodies in 491 samples from 371 HA patients.
Results
Assessments of antibody profiles showed that the presence of anti-FVIII IgG1, IgG2 or IgG4 correlated qualitatively and quantitatively with the presence of an FVIII inhibitor as determined with the Nijmegen–Bethesda assay (NBA). Forty-eight patients with a negative inhibitor history contributed serial samples to the study, including seven patients who had negative NBA titers initially and later converted to being NBA-positive. The FLI detected anti-FVIII IgG1 in five of those seven patients prior to their conversion to NBA-positive. Five of 15 serial-sample patients who had a negative inhibitor history and had anti-FVIII IgG1 later developed an inhibitor, as compared with two of 33 patients with a negative inhibitor history without anti-FVIII IgG1.
Conclusions
These data provide a rationale for future studies designed both to monitor the dynamics of anti-FVIII antibody profiles in HA patients as a potential predictor of future inhibitor development and to assess the value of the anti-FVIII FLI as a supplement to traditional inhibitor testing.
Details
- Title: Subtitle
- Characterization of the anti-factor VIII immunoglobulin profile in patients with hemophilia A by use of a fluorescence-based immunoassay
- Creators
- Brian Boylan - Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GeorgiaAnne S Rice - Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GeorgiaAmy L Dunn - Emory University, Atlanta GAMichael D Tarantino - The Bleeding and Clotting Disorders Institute, Peoria, ILDoreen B Brettler - New England Hemophilia Center, Worcester, MAJohn C Barrett - Virginia Commonwealth University, Richmond, VAConnie H Miller - Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GeorgiaHemophilia Inhibitor Research Study Investigators
- Contributors
- S R Lentz (Contributor) - University of Iowa, Internal Medicine
- Resource Type
- Journal article
- Publication Details
- Journal of thrombosis and haemostasis, Vol.13(1), pp.47-53
- DOI
- 10.1111/jth.12768
- PMID
- 25354263
- PMCID
- PMC4383171
- ISSN
- 1538-7933
- eISSN
- 1538-7836
- Grant note
- name: CDC Foundation; DOI: 10.13039/100014476, name: Pfizer Pharmaceuticals
- Language
- English
- Date published
- 01/2015
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984094520502771
Metrics
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