title: Evaluation of algorithms for the treatment of problem bleeding episodes in patients with hemophilia having inhibitors.
abstract: The correlation between real-world clinical decisions and adherence to published treatment algorithms for problem bleeding episodes in patients with severe hemophilia and inhibitors and the resultant impact on clinical outcomes were assessed. Nine cases documenting treatment for problem bleeding episodes in patients with severe hemophilia and inhibitors were retrospectively reviewed. Adherence to treatment algorithms was rated on a scale of 1 to 5, 1 being no adherence and 5 being very high adherence. Adherence ratings >3 were assigned to 7 cases in which high adherence was associated with ≤4 days to achieve hemostatic control; hospitalization for ≤7 days was noted in 6 of these cases. In cases rated ≤3 (n = 2), time to hemostatic control ranged from 5 to 8 days and hospitalization duration ranged from 10 to 16 days. These findings suggest that adherence to treatment algorithms may be beneficial in treating problem bleeding events in patients with hemophilia and inhibitors.
authors.affiliation: Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA, USA gyoung@chla.usc.edu.
authors.forename: Guy
authors.initials: G
authors.lastname: Young
authors.affiliation: Division of Hematology and Oncology, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jerome
authors.initials: J
authors.lastname: Teitel
authors.affiliation: Haemophilia Centre, APHP Bicêtre Hospital, University Paris XI, Le Kremlin-Bicêtre, France.
authors.forename: Roseline
authors.initials: R
authors.lastname: d'Oiron
authors.affiliation: Louisiana Center for Bleeding and Clotting Disorders, Tulane University School of Medicine, New Orleans, LA, USA.
authors.forename: Cindy
authors.initials: C
authors.lastname: Leissinger
authors.affiliation: Malmö Centre for Thrombosis and Haemostasis, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Berntorp
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D005169:Factor VIII / Q000037:antagonists & inhibitors / Q000276:immunology; D015942:Factor VIIa / Q000627:therapeutic use; D006467:Hemophilia A / Q000097:blood / Q000150:complications / Q000628:therapy*; D006470:Hemorrhage / Q000097:blood / Q000209:etiology / Q000628:therapy*; D006487:Hemostasis; D006801:Humans; D007518:Isoantibodies / Q000097:blood; D008297:Male; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D001779:Blood Coagulation Factors; D007518:Isoantibodies; D011994:Recombinant Proteins; C025667:prothrombin complex concentrates; D005169:Factor VIII; C103587:recombinant FVIIa; D015942:Factor VIIa
keywords: blood coagulation factors; hemophilia; hemostasis