Successful treatment by switching from activated prothrombin complex concentrate to emicizumab therapy in a hemophilia A patient with inhibitors
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- SAKAMOTO Atsushi
- Center for Postgraduate Education and Training, National Center for Child Health and Development
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- NAKADATE Hisaya
- Division of Hematology, National Center for Child Health and Development
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- WATANABE Naoki
- Department of Pediatrics, Itabashi Medical Association Hospital
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- ISHIGURO Akira
- Center for Postgraduate Education and Training, National Center for Child Health and Development Division of Hematology, National Center for Child Health and Development
Bibliographic Information
- Other Title
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- 活性型プロトロンビン複合体製剤定期投与からemicizumab療法への移行が有効であったインヒビター陽性重症血友病A
- 症例報告 活性型プロトロンビン複合体製剤定期投与からemicizumab療法への移行が有効であったインヒビター陽性重症血友病A
- ショウレイ ホウコク カッセイガタ プロトロンビン フクゴウタイ セイザイ テイキ トウヨ カラ emicizumab リョウホウ エ ノ イコウ ガ ユウコウ デ アッタ インヒビター ヨウセイ ジュウショウ ケツユウビョウ A
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Description
<p>A 7-month-old male infant with severe hemophilia A who received on-demand therapy with recombinant factor VIII (rFVIII) vomited because of acute intracranial bleeding. With rFVIII treatment for suppressing bleeding, there was development of high-titer (≤673 BU/ml) inhibitors. The patient was administered bypassing agents followed by immune tolerance induction therapy (ITI) with 50 U/kg of FVIII thrice weekly. In addition, he was treated with weekly and thrice weekly prophylaxis with 50 U/kg of activated prothrombin complex concentrate (aPCC). Despite ITI and aPCC prophylaxis treatments, it was difficult to control the hemorrhage, and the annualized bleeding ratio (ABR) remained high (5-13 bleeding episodes per year). We started emicizumab 2 weeks after completing the administration of aPCC. Weekly subdermal injections of 1.5 mg/kg emicizumab after loading dramatically decreased ABR (one bleeding episode per year), although biweekly injections of 3 mg/kg emicizumab for several months were associated with one joint hemorrhage. Compared to regular aPCC administration, our observations suggest that weekly emicizumab treatments can improve the ABR in a hemophilia patient with inhibitors and improve the quality of life of patient without limitations in terms of school events.</p>
Journal
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- Rinsho Ketsueki
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Rinsho Ketsueki 61 (6), 617-620, 2020
The Japanese Society of Hematology
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Keywords
Details 詳細情報について
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- CRID
- 1390003825195847424
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- NII Article ID
- 130007869143
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- NII Book ID
- AN00252940
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- ISSN
- 18820824
- 04851439
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- NDL BIB ID
- 030541346
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- PubMed
- 32624534
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
- PubMed
- CiNii Articles
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- Abstract License Flag
- Disallowed