Sequential therapy with activated prothrombin complex concentrate and recombinant factor VIIa in patients with severe haemophilia and inhibitors.

摘要: Summary.  Patients with haemophilia and inhibitors have bleeding episodes that can be refractory to home therapy either activated prothrombin complex concentrate (APCC) or recombinant factor VIIa (rFVIIa). Sequential these products has not been widely used because of concern regarding the possibility thrombosis. This report describes results a retrospective chart review five hospitalized children severe who treated sequential doses APCC rFVIIa for bleeding. These patients all had failed alone. A total 20 admissions were documented covering 170 hospital days, including 91 days combination therapy. While being closely monitored in hospital, they received alternating every 6 h. Anywhere from one three given 2 h between doses. Doses ranged 35 80 U kg−1 dose−1, 80 225 mcg kg−1 dose−1. There was no clinical laboratory evidence thrombosis, thrombocytopenia, disseminated intravascular coagulation (DIC). We found factors safe effective bleeds. However, we recommend this aggressive only inpatient setting careful monitoring physical examination frequent screening assess thrombosis DIC, without concurrent use antifibrinolytic medications.