Activated prothrombin complex concentrate to treat bleeding events in acquired hemophilia A: BAHAS study.
Por:
Mingot-Castellano ME, García-Candel F, Benítez-Hidalgo O, Marco A, Méndez Navarro GA, Pérez-Montes R, García Donas G, Canaro M, Paloma MJ, Asenjo B, Calle-Gordo VM, González NP, Rodríguez González R, Caparrón-Miranda IS, Quintana París L, Herrero S and Nuñez R
Publicada:
1 dic 2022
Ahead of Print:
27 ago 2022
Resumen:
OBJECTIVE: Activated prothrombin complex concentrate (aPCC) is a bypassing agent indicated to treat bleeds in patients with acquired hemophilia A (AHA). Nevertheless, its efficacy and safety in the real-world setting have not often been addressed. METHODS: We report the experience of Spanish reference centers for coagulation disorders and from acquired hemophilia Spanish Registry (AHASR) from August 2012 to February 2021. Follow-up period of 30 days after aPCC withdrawal. RESULTS: Thirty patients with a median age of 70 years old, suffering from 51 bleeds treated with aPCC were finally evaluated. As first-line treatment, aPCC stopped bleeding in 13 of 14 (92.9%) cases. aPCC as the second line after recombinant factor VIIa failure, stopped bleeding in all cases. In 17 patients, aPCC was used far from initial bleed control as prophylaxis of rebleeding with 94% effectiveness. No thromboembolic episodes were communicated. One patient developed hypofibrinogenemia, which did not prevent aPCC from halting bleeding. No other serious adverse events possibly or probably associated with aPCC were reported. CONCLUSIONS: This data support aPCC as hemostatic treatment in AHA with high effectiveness and excellent safety profile in acute bleeds and as extended use to prevent rebleedings, even in aging people with high cardiovascular risk.
Filiaciones:
Mingot-Castellano ME:
Hematology Department, Hospital Universitario Virgen del Rocio, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
Hematology Department, Hospital Regional Universitario de Málaga, Málaga, Spain
García-Candel F:
Hematology Department, Hospital Virgen de la Arrixaca, Murcia, Spain
Benítez-Hidalgo O:
Hematology Department, Hospital Vall de Hebron, Barcelona, Spain
:
Hematology Department, Hospital General de Alicante, Alicante, Spain
Méndez Navarro GA:
Hematology Department, Hospital Marqués de Valdecilla, Santander, Spain
Pérez-Montes R:
Hematology Department, Hospital Marqués de Valdecilla, Santander, Spain
García Donas G:
Hematology Department, Hospital Universitario Virgen Macarena, Sevilla, Spain
Canaro M:
Hematology Department, Hospital Son Espases, Palma de Mallorca, Spain
Paloma MJ:
Hematology Department, Hospital Universitario Virgen del Camino, Pamplona, Spain
Asenjo B:
Hematology Department, Hospital Clínico Universitario San Carlos, Madrid, Spain
Calle-Gordo VM:
Hematology Department, Hospital Torrecárdenas, Almería, Spain
González NP:
Hematology Department, Hospital Torrecárdenas, Almería, Spain
Rodríguez González R:
Hematology Department, Hospital Severo Ochoa, Madrid, Spain
Caparrón-Miranda IS:
Hematology Department, Hospital Universitario Virgen de la Victoria, Málaga, Spain
Quintana París L:
Hematology Department, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
Herrero S:
Hematology Department, Hospital Universitario de Guadalajara, Guadalajara, Spain
Nuñez R:
Hematology Department, Hospital Universitario Virgen del Rocio, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
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