IMMUNOLOGICAL STATUS OF HEMOPHILIA PATIENTS TREATED WITH CRYOPRECIPITATE OR LYOPHILIZED CONCENTRATE

Abstract

Patients (37) with moderate or severe hemophilia A and 6 patients with severe factor IX deficiency were evaluated for clinical or laboratory evidence of immune abnormalities. Patients were assigned to 1 of 4 groups according to the type of clotting factor replacement. Twenty patients had received only cryoprecipitate during the 2 yr preceding the evaluation (group I); 11 additional patients were treated predominantly with cryoprecipitate but had also received up to 9 bottles of factor VIII concentrate (group II); 6 patients received factor VIII concentrate (group III); 6 patients received factor IX concentrate (group IV). There was no clinical or laboratory evidence of immunodeficiency among the 43 patients. The mean absolute number of Th cells was normal in all patient groups, but the mean absolute number of Ts cells was increased compared with controls, both in patients treated with cryoprecipitate and in patients treated with factor VIII or factor IX concentrate. There was no correlation between the Th/Ts ratio and patient age, alanine aminotransferase level, hepatitis serology, in vitro lymphocyte function or amount of clotting factor administered. The volunteer or commercial origin of clotting factor replacement cannot fully explain the alterations in lymphocyte subset distribution previously described in patients with hemophilia A.