Minor surgical procedures during immune tolerance induction in people with hemophilia A and inhibitors: results from the Brazilian Immune Tolerance (BrazIT) study cohort

Introduction: Surgeries are implicated in the development of anti-factor VIII (FVIII) neutralizing antibodies (inhibitors) in hemophilia A individuals with immune tolerance induction (ITI) treatment being the recommended therapy to eradicate these inhibitors. We evaluated the association of surgical...

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Main Authors: Ricardo Mesquita Camelo, Maíse Moreira Dias, Suely Meireles Rezende
Format: Article
Language:English
Published: Elsevier 2024-11-01
Series:Hematology, Transfusion and Cell Therapy
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Online Access:http://www.sciencedirect.com/science/article/pii/S2531137924003031
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author Ricardo Mesquita Camelo
Maíse Moreira Dias
Suely Meireles Rezende
author_facet Ricardo Mesquita Camelo
Maíse Moreira Dias
Suely Meireles Rezende
author_sort Ricardo Mesquita Camelo
collection DOAJ
description Introduction: Surgeries are implicated in the development of anti-factor VIII (FVIII) neutralizing antibodies (inhibitors) in hemophilia A individuals with immune tolerance induction (ITI) treatment being the recommended therapy to eradicate these inhibitors. We evaluated the association of surgical procedures performed during ITI and treatment outcome. Methods: Patients were treated according to the Brazilian ITI Protocol with outcomes being defined as successful (i.e., recovered responsiveness to exogenous FVIII) and failed (i.e., unresponsiveness to exogenous FVIII thus requiring bypassing agents for bleeding control). Surgical procedures during induction therapy were managed following international recommendations. Results: Treatment success rate was 68.7 % in 163 patients; 33 (20.2 %) were submitted to 43 (96 %) minor and two major surgeries. Personal, hemophilia, inhibitor, and treatment characteristics were similar between patients submitted to surgical procedures or not while on ITI; the success rates were 72.7 % and 67.7 % (p-value = 0.577), respectively. Conclusion: No association was found between having a minor surgical procedure and ITI treatment outcome.
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spelling doaj-art-6078c7cd894344eeac7c8eca681fe9442024-12-01T05:07:47ZengElsevierHematology, Transfusion and Cell Therapy2531-13792024-11-0146S223S226Minor surgical procedures during immune tolerance induction in people with hemophilia A and inhibitors: results from the Brazilian Immune Tolerance (BrazIT) study cohortRicardo Mesquita Camelo0Maíse Moreira Dias1Suely Meireles Rezende2Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the NetherlandsFaculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, BrazilFaculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Corresponding author at: Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 190 2nd floor, room 255, Belo Horizonte, MG CEP: 30130-100, Brazil.Introduction: Surgeries are implicated in the development of anti-factor VIII (FVIII) neutralizing antibodies (inhibitors) in hemophilia A individuals with immune tolerance induction (ITI) treatment being the recommended therapy to eradicate these inhibitors. We evaluated the association of surgical procedures performed during ITI and treatment outcome. Methods: Patients were treated according to the Brazilian ITI Protocol with outcomes being defined as successful (i.e., recovered responsiveness to exogenous FVIII) and failed (i.e., unresponsiveness to exogenous FVIII thus requiring bypassing agents for bleeding control). Surgical procedures during induction therapy were managed following international recommendations. Results: Treatment success rate was 68.7 % in 163 patients; 33 (20.2 %) were submitted to 43 (96 %) minor and two major surgeries. Personal, hemophilia, inhibitor, and treatment characteristics were similar between patients submitted to surgical procedures or not while on ITI; the success rates were 72.7 % and 67.7 % (p-value = 0.577), respectively. Conclusion: No association was found between having a minor surgical procedure and ITI treatment outcome.http://www.sciencedirect.com/science/article/pii/S2531137924003031Hemophilia AInhibitorsImmune tolerance inductionSurgeryOutcome
spellingShingle Ricardo Mesquita Camelo
Maíse Moreira Dias
Suely Meireles Rezende
Minor surgical procedures during immune tolerance induction in people with hemophilia A and inhibitors: results from the Brazilian Immune Tolerance (BrazIT) study cohort
Hematology, Transfusion and Cell Therapy
Hemophilia A
Inhibitors
Immune tolerance induction
Surgery
Outcome
title Minor surgical procedures during immune tolerance induction in people with hemophilia A and inhibitors: results from the Brazilian Immune Tolerance (BrazIT) study cohort
title_full Minor surgical procedures during immune tolerance induction in people with hemophilia A and inhibitors: results from the Brazilian Immune Tolerance (BrazIT) study cohort
title_fullStr Minor surgical procedures during immune tolerance induction in people with hemophilia A and inhibitors: results from the Brazilian Immune Tolerance (BrazIT) study cohort
title_full_unstemmed Minor surgical procedures during immune tolerance induction in people with hemophilia A and inhibitors: results from the Brazilian Immune Tolerance (BrazIT) study cohort
title_short Minor surgical procedures during immune tolerance induction in people with hemophilia A and inhibitors: results from the Brazilian Immune Tolerance (BrazIT) study cohort
title_sort minor surgical procedures during immune tolerance induction in people with hemophilia a and inhibitors results from the brazilian immune tolerance brazit study cohort
topic Hemophilia A
Inhibitors
Immune tolerance induction
Surgery
Outcome
url http://www.sciencedirect.com/science/article/pii/S2531137924003031
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