Feasibility of prophylaxis and immune tolerance induction regimens in haemophilic children using fully implantable central venous catheters

British Journal of Haematology
Maria Elisa MancusoE Santagostino

Abstract

Venous access represents the major barrier to the feasibility of prophylaxis and immune tolerance induction (ITI) in haemophilic children. Ports improve treatment feasibility, but their duration is limited by infectious complications. This study aimed at evaluating whether or not ports allow haemophilic children to maintain the treatment regimen in the long term. Children were prospectively followed-up and underwent port removal either for complications or transition to peripheral veins. Of 27 ports (17 used for prophylaxis and 10 for ITI), 25 were removed after a median of 3.3 years. Inhibitor children showed a younger age at port insertion (P = 0.02), an earlier occurrence of infections (P = 0.006) at a higher rate (P = 0.00001) and an earlier removal for infection (P = 0.05) than non-inhibitor patients. Daily port use was associated with earlier infections at a higher rate compared to less frequent use (P = 0.02). Port removal after a median of 0.8 years prevented ITI completion in 50% of children, while it hampered the maintenance of prophylaxis in 27% of patients. This study showed that ports improved the feasibility of prophylaxis in the majority of non-inhibitor children, while they were not suitable for inhibitor childr...Continue Reading

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Citations

Jan 28, 2015·Haemophilia : the Official Journal of the World Federation of Hemophilia·A HarrocheC Rothschild
Jun 25, 2015·Haemophilia : the Official Journal of the World Federation of Hemophilia·A R LangleyV Blanchette
Apr 3, 2015·Haemophilia : the Official Journal of the World Federation of Hemophilia·K VepsäläinenP Riikonen
Jan 15, 2009·Haemophilia : the Official Journal of the World Federation of Hemophilia·M E MancusoE Santagostino
Nov 3, 2011·Haemophilia : the Official Journal of the World Federation of Hemophilia·S MadoiwaY Sakata
Jun 19, 2010·Haemophilia : the Official Journal of the World Federation of Hemophilia·V Rodriguez, R K Pruthi
Aug 16, 2011·Journal of Thrombosis and Haemostasis : JTH·C L EckhardtK Fijnvandraat
Jan 28, 2010·Haemophilia : the Official Journal of the World Federation of Hemophilia·E Santagostino, M E Mancuso
Jan 28, 2010·Haemophilia : the Official Journal of the World Federation of Hemophilia·G IzziA Tagliaferri
Dec 30, 2015·European Journal of Haematology·María Eva Mingot-CastellanoCarmen Sedano-Balbas
Jan 28, 2010·Haemophilia : the Official Journal of the World Federation of Hemophilia·M E Mancuso, L Berardinelli
Aug 10, 2019·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Daniel P HartMike Makris
Jul 6, 2016·Journal of Infusion Nursing : the Official Publication of the Infusion Nurses Society·Christine J Guelcher

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