ADMINISTRATION OF SINGLE DOSES OF AHF (FACTOR VIII) CONCENTRATES IN THE TREATMENT OF HEMOPHILIC HEMARTHROSES

Abstract

In the treatment of acute hemarthroses in AHF (factor VIII)-deficient patients it has been our practice to administer repeated infusions of plasma in order to maintain hemostatic levels of AHF over a 48-hour period. In the present study AHF concentrates were administered so as to provide the entire therapeutic AHF replacement in a single infusion. Fifty-one episodes of acute hemarthrosis in 14 boys with AHF deficiency were treated with plasma cryoprecipitate, glycine-precipitated factor VIII (Hyland), or a new higher potency AHF concentrate (Hyland Method 4). Single doses of 20 to 30 units of AHF activity per kilogram were given; this was sufficient to produce a post-infusion AHF level of 40 to 50%. In 47 of the 51 episodes treated, satisfactory resolution of the hemarthroses occurred without need for further AHF therapy. These results appeared at least as satisfactory as those using repeated plasma infusions. Advantages of therapy using single infusions of AHF concentrates include fewer venipunctures, ease of administration, less need for hospitalization, and greater patient acceptance. Studies of Hyland Method 4 AHF concentrate indicated that the dose-response relationship and survival of AHF activity in vivo are similar to that seen with other therapeutic forms of AHF.