Application of the STG-Bleedscreen assay in clinical routine

Objective Multiple defects can cause a bleeding diathesis. But often a single factor level is not sufficient to predict the bleeding tendency of the affected patient. Global assays, like the fully automated STG-Bleedscreen, may be better predictors of bleeding events and may help to tailor treatment.

Material and Methods Since January 2020 all patients with suspected or confirmed bleeding diathesis in our center were include in this study (with informed consent). A total of 520 measurements were performed using STG-Bleedscreen on the ST Genesia analyzer (Stago). This includes 64 measurements in samples from patients with hemophilia A, and 19 samples with hemophilia B. Results are expressed as thrombin peak in nanomolar concentration, and normalized with a standard plasma (in %).

Results In average, patients with suspected bleeding diathesis (no hemophilia) showed a normal thrombin generation of 160 ± 100 nM (normalized 107 ± 50 %). Nevertheless, patients with blood type O show significantly reduced thrombin generation accompanied with lower levels of FVIII and VWF.

Patients with hemophilia showed similar reduction of thrombin generation: 51 ± 35 nM or 36 ± 23 % for hemophilia A and 46 ± 13 nM or 31 ± 9 % for hemophilia B. The assay shows a good correlation between factor VIII level and thrombin peak, not enough data could be collected in hemophilia B. In patients receiving products with enhanced half-life, thrombin generation clearly shows the prolonged protective effect.

Conclusion The STG-Bleedscreen assay is useful in monitoring hemophilia and hemophilia treatment. Especially, the assay shows the prolonged activity of enhanced half-life products. In patients with suspected bleeding diathesis, the assay might be able to separate patients with a defect in the plasmatic coagulation system, platelets are not included in the assay.

The STG-Bleedscreen assay is a fully automated assay. It can be easily implemented in daily routine, as it does not require high technical effort. The STG-Bleedscreen shows a similar behavior compared to the manual CAT method.

Publication History

Article published online:
18 June 2021