Haemophilia A: A Comparison of Early Bleeding Therapy with Factor VIII Concentrate 250 Unit and 500 Unit

Abstract

Haemophilia A, an x-linked recessive bleeding disorder, is a lack of factor VIII that causes
patients to bleed easily. When bleeding symptom occurred, patients must be hospitalized for blood
component replacement therapy. Early bleeding therapy with factor concentrate was set up in collaboration
with National Health Security Office, Thailand, Ministry of Public Health, Hemophilia
Foundation of Thailand, and Faculty of Medicine Ramathibodi Hospital, for hemophiliac patients.
This reduced hospitalization rate to 1.9 percent. Maharat Nakhon-Ratchasima hospital joined in this
project since August 2006. In 2009, there were some problems about factor VIII concentrate 250
unit, so some hemophilia A patients whom body weight < 30 kilograms received factor VIII concentrate
500 unit. This was 2 times more than recommended dosage and raise a concern on how effective
the increase dose factor VIII concentrate in early bleeding therapy comparing between the two
pediatric haemophilia A patients.
This cross-sectional analytic study was to compare the outcome of early bleeding therapy in
pediatric hemophilia A patients with factor concentrate 250 unit and 500 unit.
A cross-sectional analytic study was carried out in pediatric haemophilia A patients in department
of pediatric Maharat Nakhon-Ratchasima hospital with body weight < 30 kilograms and underwent
early bleeding therapy with factor VIII concentrate. Their medical records from August
2006 to July 2012 were reviewed.
It was found that were there were 325 major bleeding episodes. During factor VIII concentrate
250 unit usage, there was 105 bleedng episodes, admission rate was 4.8 percent. During factor VIII
concentrate 500 unit usage, there was 220 bleeding episodes, admission rate was 2.3 percent. In
comparison of the outcomes of the treatment between factor VIII concentrate 250 unit and 500 unit
Fisher’s exact test was used showing no significant difference (p > 0.05). According to severity of
disease (subgroup analysis) Fisher’s exact test was used to compare the outcome of treatment with
factor VIII concentrate 250 unit and 500 unit and also showing no significant differences (pvalue>
0.05) among mild, moderate, severe groups.
In conclusion, early bleeding therapy in pediatric haemophilia A patients whose body weight <
30 kilograms receiving factor VIII concentrate 250 unit and 500 unit, the results of treatment is no
significant difference in statistic.
Key words: haemophilia, early bleeding therapy, factor concentrate