Effects of Chronic Factor VIII Substitution on Immune Parameters in HIV Seronegative Haemophiliacs: a Comparison between Cryoprecipitate and Factor VIII Concentrate

D P Allersmaa; W M Smld; J A van der Does; J van der Meer; E Briët

doi:10.1055/s-0038-1650257

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1996; 75(02): 261-266
DOI: 10.1055/s-0038-1650257

Original Article

Schattauer GmbH Stuttgart

Effects of Chronic Factor VIII Substitution on Immune Parameters in HIV Seronegative Haemophiliacs: a Comparison between Cryoprecipitate and Factor VIII Concentrate

D P Allersmaa

¹The Red Cross Blood Bank, The Hague, The Netherlands

,

W M Smld

²Department of Haematology, Division of Haemostasis, Thrombosis and Rheology, University Hospital Groningen, The Netherlands

,

J A van der Does

¹The Red Cross Blood Bank, The Hague, The Netherlands

,

J van der Meer

²Department of Haematology, Division of Haemostasis, Thrombosis and Rheology, University Hospital Groningen, The Netherlands

,

E Briët

³Department of Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands

› Author Affiliations

Abstract

PDF Download

Summary

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.

PDF (299 kb)

References

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
2 Watson HG, Ludlam CA. Immunological abnormalities in haemophilia. Blood Reviews 1992; 6: 26-33
3 Bemtorp E. Impact of replacement therapy on the evolution of HIV infection in hemophiliacs. Thromb Haemost 1994; 71: 678-683
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
7 Sallilas P, Barcena R, Nocito M, Erdozain J-C, Botella A, Brieva JA. Immunological abnormalities in acute post-transfusion hepatitis non-A non-B. Liver 1991; 11: 170-175
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