Abstract Number: PB1027
Meeting: ISTH 2020 Congress
Theme: Hemophilia and Rare Bleeding Disorders » Hemophilia - Clinical
Background: Recently, emicizumab (Emi) has become used for hemophilia A patients. However, it has not been known how to evaluate patients’ coagulation ability in the presence of emicizumab. Nogami et al reported that their coagulation ability was able to measure by using modified clot waveform analysis (mCWA) under a such situation.
Aims: Our objective is to clarify whether we can evaluate coagulation abilities in hemophilia A patients treated with Emi using mCWA.
Methods: We obtained plasmas drawn from seven hemophilia A patients (involved 2 with FVIII inhibitor) treated with Emi. We performed mCWA, in the same way as the method of Nogami et al, on the CS-5100 (Sysmex) instrument with a trigger reagent comprising an optimized mixture of tissue factor and ellagic acid. We divided a sample into two and stored below -80 degrees until measurement. Then, one was directly performed modified CWA, and the other was performed after incubating with anti-emicizumab antibody (AEA), which was provided by Chugai Cooperation. The parameters of mCWA were selected maximum velocity (adjusted-|min1|), coagulation maximum acceleration (adjusted-|min2|), coagulation maximum negative acceleration (adjusted-Max 2).
Results: The data of normal samples and AEA added samples measured with mCWA did not have the significant difference in all parameters. The detail was as follows. Median of adjusted-|min1| in normal samples was 4.31 (min3.70- max4.57) and that in adding samples was 4.34 (4.04- 4.43). Median of adjusted-|min2| in normal samples was 0.48 (0.40- 0.52) and that in adding samples was 0.51 (0.41- 0.53). Median of adjusted-Max 2 was 0.17(0.13- 0.18) and 0.16(0.16- 0.17), respectively.
Conclusions: This study is the first report about mCWA performed adding AEA to patients’ specimens. There was no difference of the parameters in the samples with and without AEA. mCWA may be an indicator of patients’ clotting activities in the presence of emicizumab.
To cite this abstract in AMA style:
Yamasaki N, Kajihara K, Nakagawa H, Yokozaki M, Fujii T. The Parameters of Modified Clot Waveform Analysis Using the Plasmas of Hemophilia A Patients Treated with Emicizumab [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/the-parameters-of-modified-clot-waveform-analysis-using-the-plasmas-of-hemophilia-a-patients-treated-with-emicizumab/. Accessed September 22, 2023.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/the-parameters-of-modified-clot-waveform-analysis-using-the-plasmas-of-hemophilia-a-patients-treated-with-emicizumab/