Plasma Fractionation Methods and T-Cell Subsets in Haemophilia

Lee, ChristineA.; Jánossy, G.; Ashley, Jonathan D.; Kernoff, P. B. A.

doi:10.1016/s0140-6736(83)90136-8

Cited by 29 publications

(7 citation statements)

References 10 publications

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“…Two other studies [7,8] of small groups were unable to find such correlations between concentrate consumption and lymphocyte abnormalites; in other studies [ 14,19,20], there was a trend toward lower Th/Ts ratios with increasing concentrate consumption but the relationship was not statistically significant, probably because of the small number of cases or excessive subdivision of the patients according to concentrate consumption. Unlike in some studies [8,10,17], but in agreement with others [ 141, another interesting finding in our study was that the fractionation method used in concentrate manufacturing was not an important determinant of lymphocyte abnormalities because abnormal ratios were also seen in hemophilia B patients treated with factor IX concentrates, with a similar association between large annual consumption and more pronouced abnormalities. We cannot at present explain these different findings, but it must be emphasized again that the numbers of hemophilia B patients were usually very small [8-101 in the previous studies and that only one group of investigators studied more than 20 patients [ 171.…”

supporting

confidence: 90%

“…The key laboratory abnormality in hemophiliacs (or other patient groups) who have opportunistic infections is a marked decrease in circulating Tlymphocyte predominantly due to low T-helper lymphocytes and resulting in very low T-helper (h)/T-suppressor(s) ratios [ 1-61. However, several studies have also shown a high prevalence of abnormalities of lymphocyte subsets in symptomless hemophiliacs from the United States [7-141, the United Kingdom [15][16][17], Australia [18], and Austria [19]. In these patients, the low Th/Ts ratios are usually due to an absolute or relative augmentation of Ts rather than to low absolute Th numbers as in patients with overt AIDS.…”

Section: Introductionmentioning

confidence: 99%

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Abnormalities of lymphocyte subsets are correlated with concentrate consumption in asymptomatic Italian hemophiliacs treated with concentrates made from American plasma

Gringeri

Ammassari

et al. 1984

American J Hematol

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Eighty-three symptom-free hemophiliacs were studied clinically, serologically and by in vitro tests for cellular immunity in a geographical area in which AIDS has not yet been encountered despite the exclusive use of concentrates manufactured from American sources of plasma. Some patients showed the following abnormalities: lymphopenia (4%), decreased T-helper/T-suppressor (Th/Ts) cell ratios (49%), or both abnormalities (2%). Low Th/Ts were mostly due to absolute or, less frequently, relative increases in Ts cells. The prevalence rates for these abnormalities were the same in patients treated with factor VIII or factor IX concentrates. There was an association between the higher Ts and lower Th cells counts and the low Th/Ts ratios and greater annual consumption of factor VIII and factor IX concentrates. These results support the view that protein load might be an important pathogenetic factor in lymphocyte abnormalities in symptom-free hemophiliacs.

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supporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Abnormalities of lymphocyte subsets are correlated with concentrate consumption in asymptomatic Italian hemophiliacs treated with concentrates made from American plasma

Gringeri

Ammassari

et al. 1984

American J Hematol

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“…We have previously pointed out that the relative normality of results amongst our factor IX treated patients is unlikely to be attributable to characteristics of the source plasma (Lee et al, 1983). Similarly normal results have been found in patients treated with commercial factor IX concentrates of both American and European origins (Kessler et al, 1983: Saidi et al, 1983Lechner et al, 1983).…”

Section: Ulscusstonsupporting

confidence: 72%

Relationships between blood product exposure and immunological abnormalities in English haemophiliacs

et al. 1985

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Amongst 160 English haemophiliacs treated with clotting factor concentrates, abnormalities of T lymphocyte subset distribution (characterized by low T4/T8 ratios and high total T8 counts), low in vitro phytohaemagglutinin stimulation and raised serum IgG levels, were more common in patients with haemophilia A than B, in patients who had received heavier blood product exposure, and in adults rather than children. A slight reduction in lymphocyte and platelet counts was found in 26% and 17% of patients. In the sample of patients tested, serum alpha 1-thymosin levels were often raised, but beta 2-microglobulin levels were usually normal. Fractionation procedures used to prepare clotting factor concentrates, and the amounts of concentrate used, are more likely to be causally related to these immunological abnormalities than the origins of source donor plasmas.

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“…13 14 Patients treated with prothrombin complex concentrates have generally had similar immunological findings to controls, 6 9 13 although this has not been a consistent finding.14 Thrombocytopenia, of an immune type in some cases,15 has been reported in patients with haemophilia A. 6 16 17 A relation, however, between transfused factor VIII concentrate and thrombocytopenia has not been established.…”

mentioning

confidence: 99%