Heat treatment of samples improve the performance of the Nijmegen-Bethesda assay in hemophilia A patients undergoing immune tolerance induction

Thrombosis Research
Silmara Aparecida de Lima MontalvãoM C Ozelo

Abstract

Nijmegen-Bethesda assay is the gold standard to assess inhibitory antibodies against factor (F) VIII. This method has some limitations, including high coefficient of variation and possible interference of residual endogenous or exogenous factor VIII. Heat-treatment of samples at 56°C for 30min could be a strategy to improve the sensitivity of this test. The aim of this study was to compare inhibitor quantification in hemophilia patients with and without inhibitor performed in previously heated and non-heated samples. A total of 109 analyses from 46 patients with severe hemophilia A were performed. Patients were divided into three groups: 20 patients with no history of inhibitor, recently and not recently exposed to FVIII (group I), 21 patients with history of inhibitor not exposed to FVIII (group II), and 5 patients (68 samples) undergoing an immune tolerance induction (ITI) protocol (group III). For patients with no history of inhibitor, heat-treatment did not modify the results (p=0.24). However, differences in inhibitor levels between heated and non-heated samples were observed in patients with history of inhibitor (group II, p<0.05) and in patients in ITI (group III, p<0.001). In 11 samples, inhibitor quantification shifted...Continue Reading

References

Feb 20, 2010·Seminars in Thrombosis and Hemostasis·Bert VerbruggenBritta A P Laros-van Gorkom
Mar 23, 2012·Journal of Thrombosis and Haemostasis : JTH·C H MillerUNKNOWN Hemophilia Inhibitor Research Study Investigators
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Citations

Jul 14, 2016·Haemophilia : the Official Journal of the World Federation of Hemophilia·D M AdcockS A de Lima Montalvão
Feb 16, 2018·Haemophilia : the Official Journal of the World Federation of Hemophilia·C H Miller
May 20, 2018·International Journal of Laboratory Hematology·P BattyS Platton
Feb 21, 2018·Haemophilia : the Official Journal of the World Federation of Hemophilia·B Boylan, C H Miller
Feb 13, 2019·Haemophilia : the Official Journal of the World Federation of Hemophilia·Kara A FyllingRajiv K Pruthi
Jun 8, 2018·Haemophilia : the Official Journal of the World Federation of Hemophilia·K Strandberg, J Astermark
Mar 3, 2021·Haemophilia : the Official Journal of the World Federation of Hemophilia·Paul BattyDaniel P Hart

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