Background: A bleeding diathesis can be caused by a variety of defects. A single factor level is not sufficient to predict the bleeding tendency in affected patients. Global assays, like the fully automated STG-Bleedscreen thrombin generation assay, may be better predictors of bleeding events and may help tailor treatment.

Aims: We aim to test the utility of the STG-Bleedscreen assay in diagnosis and monitoring of patients with bleeding disorders.

Methods: Patients with suspected or confirmed bleeding diathesis in our outpatient clinic were include in this study. Over 750 measurements were performed using STG-Bleedscreen on the ST Genesia analyzer (Stago). This includes about 100 samples from patients with hemophilia. Results are expressed as thrombin peak in nanomolar concentration, and normalized with a standard plasma (in %).

Results: In average, patients with suspected bleeding diathesis (no hemophilia) showed a normal thrombin generation of 153 ± 69 nM (normalized 104 ± 47 %). Nevertheless, patients with blood type O show significantly reduced thrombin generation accompanied with lower levels of FVIII and VWF.
Patients with haemophilia showed comparable reduction of thrombin generation: 53 ± 31 nM or 37 ± 22 % for haemophilia A and 48 ± 15 nM or 32 ± 10 % for hemophilia B. A good correlation between factor VIII level and thrombin peak was observed. In patients receiving enhanced half-life products, thrombin generation clearly shows the prolonged protective effect.

Conclusions: The STG-Bleedscreen assay is useful in monitoring haemophilia and treatment. Especially in the monitoring of extended half-live products, the assay reflectss the prolonged protection. In patients with suspected bleeding diathesis, the assay might be able to separate patients with a defect in the plasmatic coagulation system. The STG-Bleedscreen assay is a fully automated assay. It can be easily implemented in daily routine, as it does not require high technical effort.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/utility-of-the-stg-bleedscreen-assay-in-clinical-routine/