Abstract
In order to investigate the cause of hemolysis during the replacement therapy of hemophilia, the study on the levels of anti-A and anti-B isoagglutinin titer was carried out in three commercial factor VIII concentrates, two factor IX concentrates and two activated prothrombin complex concentrates (APCC), respectively. Furthermore, the study on the level of anti-A and anti-B isoagglutinin titer was carried out in the samples of manufacturing process of factor VIII concentrates.
It was revealed that the concentrate which was produced by the PEG-glycine method showed high level of isoagglutinin titer, while the concentrate which was produced by the DEAE cellulose method showed low level of isoagglutinin titer. Long term observation of Coombs test in three hemophiliacs receiving a large amount of factor VIII concentrate confirmed the above-mentioned results. A positive direct Coombs test was noted in one patient who received the high isoagglutinin concentrate, while direct Coombs test was negative in the other two patients who received both the low isoagglutinin concentrate and blood type specific concentrate.
The present study indicates that factor VIII concentrate which reveals low isoagglutinin titer can be used in the high dose replacement therapy of hemophiliacs instead of blood type specific concentrate.
