Effects of Chronic Factor VIII Substitution on Immune Parameters in HIV Seronegative Haemophiliacs: a Comparison between Cryoprecipitate and Factor VIII Concentrate
D P Allersmaa
1
The Red Cross Blood Bank, The Hague, The Netherlands
,
W M Smld
2
Department of Haematology, Division of Haemostasis, Thrombosis and Rheology, University Hospital Groningen, The Netherlands
,
J A van der Does
1
The Red Cross Blood Bank, The Hague, The Netherlands
,
J van der Meer
2
Department of Haematology, Division of Haemostasis, Thrombosis and Rheology, University Hospital Groningen, The Netherlands
,
E Briët
3
Department of Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands
Chronic substitution therapy of HIV-negative haemophiliacs with factor VIII products can result in abnormalities of ex-vivo measured immune parameters. To assess a possible relation between these abnormalities and product purity, we analyzed two groups of HIV-negative HCV-positive haemophiliacs, one treated with cryoprecipitate exclusively, the other with more purified factor VIII concentrates. Compared to age matched non-transfused male controls, increased numbers of white cells, granulocytes, IgG and IgM levels and decreased CD4+/CD8+ ratios were found in both patient groups. In the concentrate receivers, the numbers of mononuclear cells, CD4+, CD8+ and CD3+/HLA-DR+ cells indicating activated T-cells, were higher than in the cryoprecipitate group. In conclusion, both cryoprecipitate and intermediate/high purity concentrate recipients showed immune parameter abnormalities. These abnormalities tended to be somewhat more pronounced in patients treated with concentrates. By now there is no indication of the clinical relevance of the abnormalities in previously treated HIV seronegative haemophiliacs.
References
1
Gomperts ED,
de Biasi R,
De Vreker R.
The impact of clotting factor concentrates on the immune system in individuals with hemophilia. Transfus Med Rev 1992; 6: 44-54
4
de Biasi R,
Rocino A,
Miraglia E,
Mastrullo L,
Quirino AA.
The impact of a very high purity factor VIII concentrate on the immune system of human immunodeficiency virus-infected haemophiliacs: a randomized, prospective, two-year comparison with an intermediate purity concentrate. Blood 1991; 78: 1919-1922
5
Seremitis SV,
Aledort LM,
Bergman GE,
Bona R,
Bray G,
Brettler D,
Eyster ME,
Kessler C,
Lau TS,
Lusher J,
Rickies F.
Three-year randomised study of high-purity or intermediate-purity factor VIII concentrates in symptom-free HIV-seropositive hemophiliacs: effects on immune status. Lancet 1993; 342: 700-703
6
Mannucci PM,
Brettler DB,
Aledort LM,
Lusher JM,
Abildgaard CF,
Schwartz RS,
Hurst D.
Kogenate Study Group. Immune status of human immunodeficiency virus seropositive and seronegative hemophiliacs infused for 3.5 years with recombinant factor VIII. Blood 1994 83. 1958-1962
8
Mauser-Bunschoten EP,
Bresters D,
van Drimmelen AAJ,
Roosendaal G,
Cuypers HTM,
Reesink HW,
van der Poel CL,
van den Berg HM,
Lelie PN.
Hepatitis C infection and viremia in Dutch hemophilia patients. J Med Vir 1995; 45: 241-246
9
Shannon BT,
Roach J,
Cheek-Luten M,
Orosz C,
Ruymann FB.
Progressive change in lymphocyte distribution and degree of hypergammaglobulinemia with age in children with hemophilia. J Clin Immunol 1986; 6: 121-129
10
Jason J,
Holman RC,
Evatt BL.
the hemophilia-AIDS collaborative study group. Relationship of partially purified factor concentrates to immune tests and AIDS Am J Hematol 1990 34. 262-269
11
Hassett J,
Gjerset GF,
Mosley JW,
Fletcher MA,
Donegan E,
Parker JW,
Counts RB,
Aledort LM,
Lee M,
Pike MC.
the transfusion safety study group. Effect on lymphocyte subsets of clotting factor therapy in human immunodeficiency virus-1-negative congenital clotting disorders. Blood 1993; 82: 1351-1357
12
Smit C,
Rosendaal FR,
Varekamp I,
Briicker-Vriends AHJT,
Van Dijck H,
Suurmeijer ThPBM,
Briet E.
Physical condition, longevity, and social performance of Dutch haemophiliacs, 1972-85. Br Med J 1989; 298: 235-238
13
Rosendaal FR,
Varekamp I,
Smit C,
Briicker-Vriends AHJT,
Van Dijck H,
Vandenbroucke JP,
Hermans J,
Suurmeijer TPBM,
Briet E.
Mortality and causes of death in Dutch haemophiliacs, 1973-87. Br J Haem 1989; 71: 71-76
14
Triemstra AHM,
Smit C,
van der Ploeg HM,
Briet E,
Rosendaal FR.
Two decades of haemophilia treatment in the Netherlands, 1972-1992. Haemophilia; in press
15
Funk M,
Ebener U,
Kreuz W.
Immune status of HIV and HCV negative haemophiliacs treated with intermediate-purity factor VIII concentrates. Lancet 1993; 342: 933-934
