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Discrepancy Between the Results of One-Stage and Chromogenic Factor Viii:C Assays in Patients With Mild/Moderate Hemophilia A Publisher Pubmed



Vosough F1 ; Ahmadinejad M1 ; Toogeh G2 ; Karimi K2 ; Homayoun S1 ; Managhchi MR2 ; Arabkhazaeli A1
Authors
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Authors Affiliations
  1. 1. Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, IBTO bldg, Hemmat Exp. Way, Next to the Milad Tower, Tehran, 14665-1157, Iran
  2. 2. Thrombosis Hemostasis Research Center, Tehran University of Medical Sciences, Tehran, Iran

Source: Blood Coagulation and Fibrinolysis Published:2020


Abstract

Diagnosis of hemophilia A is generally based on the measurement of plasma factor VIII activity (FVIII:C) using the one-stage assay (OSA) or the two-stage chromogenic substrate assay (CSA). The results of these methods show considerable discrepancy in about one-third of non-severe hemophilia A patients. The aim of this study was to assess the prevalence of FVIII:C assay discrepancy in non-severe hemophilia A patients in Iran and the relationship between the bleeding tendency with the level of FVIII:C by each method. Patients registered as mild or moderate hemophilia A in hemophilia clinic of Imam Khomeini Hospital were included. In each patient, FVIII:C level was assessed using one-stage (FVIII:C1) and chromogenic (FVIII:CR) methods. Assay discrepancy was defined as a two-fold or greater difference between the results of two assays. Bleeding tendency of the patients was recorded based on ‘ISTH-BAT’. Sixty male patients were eligible for the study. The levels of FVIII:C1 was higher than FVIII:CR in 90% of patients. Assay discrepancy was seen in 41 (68%) patients. The classification of hemophilia A in 23 (38%) patients was modified by chromogenic method. No significant correlation was noted between the results of ISTH BAT with FVIII:C levels of each method. Regarding the prevalence of FVIII:C assay discrepancy in 2/3 of our non-severe hemophilia A patients, high rate of disease severity modification by chromogenic method and no significant relation between the clinical bleeding phenotype with any method, the authors highly recommend to perform both FVIII:C assays for the diagnosis and classification of non-severe hemophilia A. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
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