title: The efficacy and safety of lyophilized cryoprecipitate in hemophilia A.
abstract: This prospective study of assessing the efficacy and safety of lyophilized cryoprecipitate (LC), which was heat-treated at 60 degrees C for 25 hours, was conducted in 23 patients with hemophilia A (severe 13, moderate 9, mild 1) at the International Hemophilia Training Center, Bangkok from 1997 to 1998. A total of 223 infusions of LC were given. The status of the patients could be classified into 4 groups: group I, non-bleeding (n = 13); group II, severe bleeding requiring hospitalization (n = 9); group III, appendectomy (n = 1) and group IV, early bleeding controlled by modified home treatment (n = 200). Pharmacokinetic studies were conducted in groups I and II. The mean in vivo half-life of factor VIII clotting activity (F VIII:C) was 12.6 hours and the mean in vivo incremental recovery at baseline was 2.1 per cent/unit/kg. The mean clearance was 3.22 ml/kg/h. There was no statistically significant difference in these parameters between groups I and II (p > 0.05). The hemostasis was successfully achieved and 1 to 2 small urticarial wheals were observed in only 2 infusions. In addition, 9 out of 23 patients received LC exclusively for 1 year. None of them developed inhibitor to F VIII:C nor did any contract additional transfusion-transmitted infection except one who developed anti-hepatitis C virus seroconversion after receiving 16 bottles of LC in 4 months. Therefore, the more efficient virus-inactivation in the preparation of LC should be established.
authors.affiliation: International Hemophilia Training Center-Bangkok, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand.
authors.forename: A
authors.initials: A
authors.lastname: Chuansumrit
authors.forename: P
authors.initials: P
authors.lastname: Isarangkura
authors.forename: A
authors.initials: A
authors.lastname: Chantanakajornfung
authors.forename: K
authors.initials: K
authors.lastname: Kuhathong
authors.forename: P
authors.initials: P
authors.lastname: Pintadit
authors.forename: C
authors.initials: C
authors.lastname: Jitpraphai
authors.forename: P
authors.initials: P
authors.lastname: Hathirat
authors.forename: C
authors.initials: C
authors.lastname: Nuchprayoon
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005169:Factor VIII / Q000627:therapeutic use*; D005612:Freeze Drying; D006467:Hemophilia A / Q000628:therapy*; D006801:Humans; D007223:Infant; D011446:Prospective Studies; D014775:Virus Activation
chemical_list: D005169:Factor VIII