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Assessment of joint health in females with haemophilia: The carriers ultrasound project (CUP) study 血友病女性患者关节健康评估:带菌者超声波项目(CUP)研究。
IF 3 2区 医学 Q2 HEMATOLOGY Pub Date : 2024-11-27 DOI: 10.1111/hae.15128
Fernando F. Corrales-Medina, Kelli Fraga, Maria D'Almeida Bastos, Amina Rafique, Christine L. Kempton, Pooja Vijayvargia, Joanna A. Davis, Rachel S. Kronenfeld

Introduction

The needs of haemophilia carriers (HC) have been historically overlooked. It is now recognised that HC manifests bleeding symptoms, including haemarthrosis. The natural history of joint health in HC is not yet defined.

Aim

A multi-institutional cross-sectional study aimed to evaluate the characteristics of joint disease in HC, aged 18–40 years, compared to age-matched controls.

Methods

The carrier cohort included females with confirmed HC status. Controls had no personal or family history of bleeding disorders. All females with a history of joint trauma or surgery within 12 months or any history of joint replacement were excluded. Joint health was assessed by clinical history, Haemophilia Joint Health Score (HJHS) and point-of-care musculoskeletal ultrasonography (POC-MSKUS).

Results

Thirty HC and 30 controls were enrolled. For HC, the median factor activity level was 52% (range 17%–100%). Carriers, regardless of baseline factor activity levels, reported higher prevalence of chronic joint pain (p < .001) and swelling (p = .002) than controls. Heavy menstrual bleeding, epistaxis, gingival bleeding and easy bruising were also more prevalent in HC (p < .001). Despite HC having a higher median HJHS score (5 vs. 0, p < .001), no differences were observed when using POC-MSKUS. HC with a body mass index ≥25 mg/m2 reported more haemarthrosis (p = .037).

Conclusions

HC are at increased risk of joint-related symptoms and poorer joint health than age-matched controls. Dedicated follow-up to prevent and treat joint disease in HC is imperative. This study is also a call for additional investigation to clarify the association, or lack thereof, between factor activity and joint disease.

导言:血友病携带者(HC)的需求历来被忽视。现在人们已经认识到,血友病携带者会出现出血症状,包括血液性关节病。目的:一项多机构横断面研究旨在评估 18-40 岁血友病携带者的关节疾病特征,并与年龄匹配的对照组进行比较:方法:带菌者队列包括确诊为HC的女性。对照组无出血性疾病的个人或家族史。所有在 12 个月内有关节外伤或手术史或任何关节置换史的女性均被排除在外。关节健康状况通过临床病史、血友病关节健康评分(HJHS)和护理点肌肉骨骼超声波检查(POC-MSKUS)进行评估:结果:共招募了 30 名血友病患者和 30 名对照组患者。HC的因子活性水平中位数为52%(范围为17%-100%)。无论基线因子活动水平如何,携带者均报告了较高的慢性关节疼痛发生率(p 2),并报告了较多的血性关节炎(p = .037):与年龄匹配的对照组相比,高危人群出现关节相关症状的风险更高,关节健康状况更差。当务之急是对高危人群进行专门的随访,以预防和治疗关节疾病。这项研究还呼吁开展更多调查,以明确因子活动与关节疾病之间是否存在关联。
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引用次数: 0
A core outcome set for prophylaxis and perioperative treatment of von Willebrand disease: The coreVWD initiative 冯-威廉氏病的预防和围手术期治疗核心结果集:核心 VWD 计划。
IF 3 2区 医学 Q2 HEMATOLOGY Pub Date : 2024-11-27 DOI: 10.1111/hae.15122
Elizabeth Clearfield, Benjamin Kim, Sarah Ford, Nathan T. Connell, Maria E. Santaella, Michelle Lavin, Manon E. L. Degenaar-Dujardin, Emily Ayoub, Veronica H. Flood, Dawn Rotellini, Mark W. Skinner, Paula James, the coreVWD Panel

Introduction

Treatment options are expanding for von Willebrand disease (VWD). A core outcome set (COS)—a minimum set of agreed-upon outcomes to be used in every clinical trial for a given condition—provides guidance on which outcomes are most important to measure to ensure necessary data is collected for a variety of stakeholders and enable comparison across products and trials.

Aim

coreVWD aimed to develop a COS for trials for prophylaxis and perioperative treatments for VWD.

Methods

A modified Delphi consensus process was used to condense/prioritize a long list of potential outcomes. Over three Delphi rounds, a multi-stakeholder panel (patients, clinicians, pharmaceutical company representatives, HTA organizations, payer, and government organization representatives) rated each outcome from 1 (not important to include in a COS) to 9 (essential to include). Outcomes were eliminated or retained based on pre-determined criteria; a special provision to elevate patient priorities was included. An in-person consensus meeting was held after Delphi round 2.

Results

Thirty-nine panellists participated. The final COS for prophylaxis treatment included 18 outcomes, seven of which are part of a special subset selected for women, girls and people with the potential to menstruate. There were 11 outcomes in the final perioperative branch COS. Six outcomes overlapped both COS.

Conclusions

The coreVWD COS represents a consensus list of outcomes for clinical trials for both factor and non-factor VWD therapies. These outcomes will be useful across the lifecycle of a product, from clinical development through regulatory and market access phases and into patient-provider decision-making.

导言:冯-威廉氏病(VWD)的治疗方案正在不断扩大。核心结果集(COS)是针对特定病症的每项临床试验所使用的最低限度的商定结果集,它为哪些结果是最重要的测量结果提供了指导,以确保为各种利益相关者收集必要的数据,并能对不同产品和试验进行比较:方法:采用改良的德尔菲共识流程,对一长串潜在结果进行压缩/优先排序。在三轮德尔菲讨论中,多方利益相关者小组(患者、临床医生、制药公司代表、HTA 组织、支付方和政府组织代表)对每项结果的评分从 1 分(不重要,不纳入 COS)到 9 分(必须纳入)不等。根据预先确定的标准对结果进行剔除或保留;其中包括一项提高患者优先级的特别规定。德尔菲第二轮结束后,召开了一次面对面的共识会议:结果:39 位小组成员参加了会议。预防性治疗的最终 COS 包括 18 项结果,其中 7 项属于为妇女、女童和有月经可能的人选择的特殊子集。最终的围手术期分支 COS 共有 11 项结果。有六项结果与两个 COS 重叠:VWD核心COS代表了因子和非因子VWD疗法临床试验结果的共识清单。这些结果将在产品的整个生命周期中发挥作用,从临床开发到监管和市场准入阶段,再到患者-提供者决策。
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引用次数: 0
UKHCDO gene therapy taskforce: Guidance for implementation of haemophilia gene therapy into routine clinical practice for adults 英国血友病组织基因治疗工作组:成人血友病基因治疗常规临床实践实施指南。
IF 3 2区 医学 Q2 HEMATOLOGY Pub Date : 2024-11-20 DOI: 10.1111/hae.15125
Pratima Chowdary, Beatriz Duran, Paul Batty, Gillian Lowe, April Jones, Debra Pollard, Sara Boyce, Jayashree Motwani, Bahareh Amirloo, Kathryn Musgrave, David Hopper, Stephen Classey, Sarah Whitaker, Nicola Dunn, Annette Bowyer, Susan Shapiro

Introduction

2022 was a landmark year with two adeno-associated viral vectors (AAVs) receiving conditional marketing authorization from EMA for the treatment of persons with severe haemophilia A and severe to moderately severe haemophilia B and a third in 2024. Gene therapy is a transformative, irreversible treatment with long-lasting effects, necessitating development of new clinical pathways to ensure optimal outcomes.

Aim

To develop a consensus framework and service specification for delivery of AAV gene therapy for haemophilia in adults within the UK using the hub-and-spoke model proposed by the European Association of Haemophilia and Allied Disorders and the European Haemophilia Consortium.

Methods

The UK Haemophilia Centre Doctors Organisation (UKHCDO) set up a working party to develop expert consensus guidance, working with NHS England to ensure alignment with NHS England commissioning and the national service specification.

Results

These guidelines detail the patient pathway, counselling and governance requirements for the hub-and-spoke model. The national service specification requires the hub site to manage governance for AAV-based gene therapy. Proposed regional and national multidisciplinary teams will harmonize clinical practices incorporating expertise from various specialities and professional groups. Key requirements identified include standardized documentation and multidisciplinary collaboration. Nationally agreed patient information and counselling checklists will streamline the informed consent process and facilitate data collection for long-term safety and efficacy monitoring.

Conclusion

These guidelines provide a structured framework for the delivery of liver-directed gene therapy. Whilst specific to the United Kingdom they provide a framework for the implementation of gene therapy in other countries for haemophilia and other monogenic disorders.

导言:2022 年是具有里程碑意义的一年,两款腺相关病毒载体(AAV)获得了欧洲药品管理局(EMA)的有条件上市许可,用于治疗重度血友病 A 患者和重度至中度血友病 B 患者,第三款 AAV 将于 2024 年上市。目的:采用欧洲血友病及相关疾病协会(European Association of Haemophilia and Allied Disorders)和欧洲血友病联盟(European Haemophilia Consortium)提出的 "中心辐射"(hub-and-spoke)模式,制定英国成人血友病 AAV 基因疗法的共识框架和服务规范:方法:英国血友病中心医生组织(UKHCDO)成立了一个工作小组,与英格兰国家医疗服务体系合作制定专家共识指南,确保与英格兰国家医疗服务体系的委托和国家服务规范保持一致:这些指南详细介绍了中心辐射模式的患者路径、咨询和管理要求。国家服务规范要求中心站对基于 AAV 的基因治疗进行管理。拟议中的地区和国家多学科团队将协调临床实践,吸收各专科和专业团体的专业知识。已确定的主要要求包括标准化文件和多学科协作。全国统一的患者信息和咨询核对表将简化知情同意程序,促进长期安全性和疗效监测数据的收集:这些指南为肝脏定向基因疗法的实施提供了一个结构化框架。虽然这些指南仅适用于英国,但它们为其他国家实施血友病和其他单基因遗传疾病的基因疗法提供了框架。
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引用次数: 0
Assessment of haemophilic joints in a low-resourced area using clinical tools: The effect of different types of prophylaxis 利用临床工具评估资源匮乏地区的嗜血关节:不同类型预防措施的效果。
IF 3 2区 医学 Q2 HEMATOLOGY Pub Date : 2024-11-17 DOI: 10.1111/hae.15115
Ilham Youssry, Rania El-Taweel, Hadeel Seif, Rania Sami, Karim Okasha, Ebtehal Taha, Assad Haffar, Marwa Abd Elhady

Introduction

Haemophilic arthropathy (HA) is the most frequent complication in people with haemophilia (PWH). MRI is the gold standard to assess HA, however, there are limitations to its use in low-resourced areas.

Aim

Primary; to compare clinical-functional, laboratory, and ultrasonographic joint scores with MRI scores to determine a reasonable alternative to MRI. Secondary; to identify the effect of various replacement therapies on the degree of joint involvement.

Material and method

Fifty PWH with at least one affected joint, with or without inhibitors, and receiving either on-demand treatment or secondary prophylaxis, were included. All participants had a joint assessment by clinical HJHS 2.1, functional FISH, HEAD-US, and MRI DENVER scores. Also, serum COMP level was assessed by ELISA for the PWH and 50 healthy subjects as control.

Results

The HJHS 2.1 scores had a significant positive correlation with HEAD-US and the MRI DENVER scores. The FISH score had a significant negative correlation with HJHS 2.1, HEAD-US, and MRI DENVER Scores. The serum COMP level was comparable between the PWH and the controls. The HEAD-US score had a significant positive correlation with the MRI score. All of the joints’ scores for the PWH on Emicizumab prophylaxis showed significantly lower HJHS 2.1 and MRI DENVER scores but higher FISH score than the joint scores of the patients receiving other types of prophylaxis.

Conclusion

The clinical-functional joints assessment scores (HJHS 2.1, FISH) were objective tools that correlated significantly with the HEAD-US and the Denver MRI scores. Emicizumab prophylaxis led to better joint status.

导言:血友病关节病(HA)是血友病患者最常见的并发症。核磁共振成像是评估血友病关节病的金标准,但在资源匮乏的地区使用存在局限性。目的:主要目的是比较临床功能、实验室和超声关节评分与核磁共振成像评分,以确定核磁共振成像的合理替代方案。次要目的:确定各种替代疗法对关节受累程度的影响:纳入 50 名至少有一个关节受累的 PWH,无论是否患有抑制剂,接受按需治疗或二级预防治疗。所有参与者均通过临床 HJHS 2.1、功能性 FISH、HEAD-US 和 MRI DENVER 评分进行了关节评估。此外,还用 ELISA 方法评估了 PWH 和 50 名健康对照者的血清 COMP 水平:结果:HJHS 2.1 评分与 HEAD-US 和 MRI DENVER 评分呈显著正相关。FISH 评分与 HJHS 2.1、HEAD-US 和 MRI DENVER 评分呈显著负相关。PWH 和对照组的血清 COMP 水平相当。HEAD-US 评分与 MRI 评分呈显著正相关。与接受其他类型预防治疗的患者相比,接受埃米珠单抗预防治疗的PWH患者的所有关节评分均显示HJHS 2.1和MRI DENVER评分明显较低,但FISH评分较高:结论:临床关节功能评估评分(HJHS 2.1 和 FISH)是一种客观工具,与 HEAD-US 和丹佛 MRI 评分有显著相关性。埃米珠单抗预防性治疗可改善关节状况。
{"title":"Assessment of haemophilic joints in a low-resourced area using clinical tools: The effect of different types of prophylaxis","authors":"Ilham Youssry,&nbsp;Rania El-Taweel,&nbsp;Hadeel Seif,&nbsp;Rania Sami,&nbsp;Karim Okasha,&nbsp;Ebtehal Taha,&nbsp;Assad Haffar,&nbsp;Marwa Abd Elhady","doi":"10.1111/hae.15115","DOIUrl":"10.1111/hae.15115","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Haemophilic arthropathy (HA) is the most frequent complication in people with haemophilia (PWH). MRI is the gold standard to assess HA, however, there are limitations to its use in low-resourced areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p><b>Primary</b>; to compare clinical-functional, laboratory, and ultrasonographic joint scores with MRI scores to determine a reasonable alternative to MRI. <b>Secondary</b>; to identify the effect of various replacement therapies on the degree of joint involvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and method</h3>\u0000 \u0000 <p>Fifty PWH with at least one affected joint, with or without inhibitors, and receiving either on-demand treatment or secondary prophylaxis, were included. All participants had a joint assessment by clinical HJHS 2.1, functional FISH, HEAD-US, and MRI DENVER scores. Also, serum COMP level was assessed by ELISA for the PWH and 50 healthy subjects as control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The <b><span>HJHS</span> <span>2</span><span>.</span><span>1</span></b> scores had a significant positive correlation with HEAD-US and the MRI DENVER scores. The <b><span>FISH score</span></b> had a significant negative correlation with HJHS 2.1, HEAD-US, and MRI DENVER Scores. The <b><span>serum COMP</span></b> level was comparable between the PWH and the controls. The HEAD-<b><span>US score</span></b> had a significant positive correlation with the MRI score. All of the joints’ scores for the PWH on Emicizumab prophylaxis showed significantly lower HJHS 2.1 and MRI DENVER scores but higher FISH score than the joint scores of the patients receiving other types of prophylaxis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The clinical-functional joints assessment scores (HJHS 2.1, FISH) were objective tools that correlated significantly with the HEAD-US and the Denver MRI scores. Emicizumab prophylaxis led to better joint status.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"30 6","pages":"1414-1421"},"PeriodicalIF":3.0,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Challenges in the diagnosis and management of patients with rare coagulation disorders in Lebanon and consequences of a social and economic crisis 黎巴嫩罕见凝血障碍患者诊断和管理方面的挑战以及社会和经济危机的后果。
IF 3 2区 医学 Q2 HEMATOLOGY Pub Date : 2024-11-15 DOI: 10.1111/hae.15123
Roula Farah, Michel Boustany, Philippe Saad, Alessandro Casini, Philippe de Moerloose

Introduction

Rare coagulation disorders (RCDs) constitute an important health risk. Data on epidemiology, quality of life (QoL), access to care, and impact of the ongoing economic crisis on RCDs in Lebanon is limited.

Aim

We aimed to address these gaps by evaluating effect of the crisis on the management of RCDs.

Methods

We performed a retrospective chart review of RCD pediatric patients in a tertiary hospital between 2003 and 2023. Patients with deficiencies of fibrinogen, factor (F)II, FV, combined FV and FVIII, FVII, FXI, FXII, FXIII, and congenital deficiency of vitamin K-dependent factors (VKCFDs) underwent a qualitative assessment of the impact of the economic crisis on care and quality of life by an interview aimed at investigating obstacles to diagnosis, disparities in access to treatment, impact of the crisis on QoL and disease management, and opinion on governmental efforts to solve the health crisis.

Results

46 patients were included. The response rate for the interview was 63%. Among the cohort, 21 (72.4%) reported difficulty accessing treatment since the start of the crisis and 18 (62%) reported “lack of healthcare coverage for necessary treatments” as the main issue. Most participants reported that the Lebanese government did not adequately address their needs during the crisis.

Conclusion

Our study showcased that management of RCD patients in Lebanon has been severely affected by the economic crisis. Combined efforts by public and private sectors are needed to appropriately address this issue. Lessons can be learned from the Lebanese experience to appropriately screen for actionable factors in vulnerable populations.

导言:罕见凝血功能障碍(RCD)是一种重要的健康风险。有关黎巴嫩罕见凝血障碍的流行病学、生活质量(QoL)、就医途径以及当前经济危机对罕见凝血障碍的影响的数据十分有限:我们对一家三甲医院 2003 年至 2023 年间的 RCD 儿科患者进行了回顾性病历审查。纤维蛋白原、因子 (F)II、FV、FV 和 FVIII 合并、FVII、FXI、FXII、FXIII 以及维生素 K 依赖性因子先天缺乏症 (VKCFDs) 缺乏症患者通过访谈接受了经济危机对护理和生活质量影响的定性评估,访谈旨在调查诊断障碍、获得治疗方面的差异、危机对生活质量和疾病管理的影响以及对政府为解决健康危机所做努力的看法:共纳入 46 名患者。访谈回复率为 63%。其中 21 人(72.4%)表示自危机开始以来难以获得治疗,18 人(62%)表示 "缺乏必要治疗的医疗保险 "是主要问题。大多数参与者表示,黎巴嫩政府在危机期间没有充分满足他们的需求:我们的研究表明,黎巴嫩的 RCD 患者管理受到了经济危机的严重影响。需要公共和私营部门共同努力,才能妥善解决这一问题。我们可以从黎巴嫩的经验中汲取教训,适当筛查弱势人群中的可操作因素。
{"title":"Challenges in the diagnosis and management of patients with rare coagulation disorders in Lebanon and consequences of a social and economic crisis","authors":"Roula Farah,&nbsp;Michel Boustany,&nbsp;Philippe Saad,&nbsp;Alessandro Casini,&nbsp;Philippe de Moerloose","doi":"10.1111/hae.15123","DOIUrl":"10.1111/hae.15123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Rare coagulation disorders (RCDs) constitute an important health risk. Data on epidemiology, quality of life (QoL), access to care, and impact of the ongoing economic crisis on RCDs in Lebanon is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>We aimed to address these gaps by evaluating effect of the crisis on the management of RCDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective chart review of RCD pediatric patients in a tertiary hospital between 2003 and 2023. Patients with deficiencies of fibrinogen, factor (F)II, FV, combined FV and FVIII, FVII, FXI, FXII, FXIII, and congenital deficiency of vitamin K-dependent factors (VKCFDs) underwent a qualitative assessment of the impact of the economic crisis on care and quality of life by an interview aimed at investigating obstacles to diagnosis, disparities in access to treatment, impact of the crisis on QoL and disease management, and opinion on governmental efforts to solve the health crisis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>46 patients were included. The response rate for the interview was 63%. Among the cohort, 21 (72.4%) reported difficulty accessing treatment since the start of the crisis and 18 (62%) reported “lack of healthcare coverage for necessary treatments” as the main issue. Most participants reported that the Lebanese government did not adequately address their needs during the crisis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study showcased that management of RCD patients in Lebanon has been severely affected by the economic crisis. Combined efforts by public and private sectors are needed to appropriately address this issue. Lessons can be learned from the Lebanese experience to appropriately screen for actionable factors in vulnerable populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"31 1","pages":"63-68"},"PeriodicalIF":3.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
One day at a time: Life with Glanzmann thrombasthenia – Qualitative results from the GT 360 study 一天一天过:格兰兹曼血栓形成症患者的生活--GT 360 研究的定性结果。
IF 3 2区 医学 Q2 HEMATOLOGY Pub Date : 2024-11-15 DOI: 10.1111/hae.15126
Kate Khair, Simon Fletcher, Kathryn Jenner, Michael Holland

Introduction

Glanzmann thrombasthenia (GT) is a platelet function disorder. Symptoms include bruising and bleeding, which may be severe and life-threatening. The day-to-day experiences of those affected remain poorly documented.

Aims

The Glanzmann's 360 study aimed to better understand the daily realities of living with GT, exploring psychological, social and medical challenges to identify unmet need.

Methods

People with GT over 18 and caregivers of children with GT participated. Mixed methods research was used, including a survey and in-depth interviews. The interviews, reported here, were audio-recorded, transcribed and thematically analysed.

Results

Nineteen interviews were conducted; 14 with people with GT and five caregivers. Mean age of those with GT was 32.9 years (range 2–78 years). Eight themes emerged: Diagnosis, Bleeding and Treatment, Menstruation, Fatigue, Identity, Abuse, Pregnancy, and The Future. Three participants described misdiagnosis. Caregivers reported early recognition and prompt diagnosis of their children. Bruising, the most commonly reported symptom, led to assumption of abuse. Six (32%) participants reported joint bleeds. External bleeding was normalised. Access to home treatment and local care were limited. Fatigue caused by anaemia was described. All women reported heavy menstrual bleeding. Choices around pregnancy were limited by ‘medical pessimism’. Nevertheless, participants remained hopeful for the development of improved treatment options.

Conclusion

People with GT face significant and often overlooked challenges. There is need for improved medical and psychological treatment and support, increased awareness of these needs amongst healthcare professionals, and research into developing comprehensive care models that address medical and psychosocial needs of people with GT.

导言格兰兹曼血栓形成症(GT)是一种血小板功能失调症。症状包括瘀伤和出血,严重时可危及生命。格兰兹曼 360 研究旨在更好地了解 GT 患者的日常生活现状,探讨心理、社会和医疗方面的挑战,以确定尚未满足的需求:方法:18 岁以上的 GT 患者和 GT 儿童的照顾者参与了这项研究。研究采用了混合方法,包括调查和深入访谈。本文报告的访谈均经过录音、转录和主题分析:共进行了 19 次访谈,其中 14 次针对 GT 患者,5 次针对照顾者。GT 患者的平均年龄为 32.9 岁(2-78 岁不等)。出现了八个主题:诊断、出血和治疗、月经、疲劳、身份、虐待、怀孕和未来。三名参与者描述了误诊情况。照顾者报告说,他们的孩子得到了早期识别和及时诊断。瘀伤是最常报告的症状,这导致了对虐待的假设。六名参与者(32%)报告了关节出血。外伤出血已恢复正常。获得家庭治疗和当地护理的机会有限。贫血导致的疲劳也有所描述。所有妇女都报告有大量月经出血。医疗悲观主义 "限制了她们对怀孕的选择。尽管如此,参与者仍对改进治疗方案充满希望:结论:GT 患者面临着巨大的、往往被忽视的挑战。有必要改善医疗和心理治疗及支持,提高医护人员对这些需求的认识,并研究开发综合护理模式,以满足 GT 患者的医疗和心理需求。
{"title":"One day at a time: Life with Glanzmann thrombasthenia – Qualitative results from the GT 360 study","authors":"Kate Khair,&nbsp;Simon Fletcher,&nbsp;Kathryn Jenner,&nbsp;Michael Holland","doi":"10.1111/hae.15126","DOIUrl":"10.1111/hae.15126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Glanzmann thrombasthenia (GT) is a platelet function disorder. Symptoms include bruising and bleeding, which may be severe and life-threatening. The day-to-day experiences of those affected remain poorly documented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The Glanzmann's 360 study aimed to better understand the daily realities of living with GT, exploring psychological, social and medical challenges to identify unmet need.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>People with GT over 18 and caregivers of children with GT participated. Mixed methods research was used, including a survey and in-depth interviews. The interviews, reported here, were audio-recorded, transcribed and thematically analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nineteen interviews were conducted; 14 with people with GT and five caregivers. Mean age of those with GT was 32.9 years (range 2–78 years). Eight themes emerged: Diagnosis, Bleeding and Treatment, Menstruation, Fatigue, Identity, Abuse, Pregnancy, and The Future. Three participants described misdiagnosis. Caregivers reported early recognition and prompt diagnosis of their children. Bruising, the most commonly reported symptom, led to assumption of abuse. Six (32%) participants reported joint bleeds. External bleeding was normalised. Access to home treatment and local care were limited. Fatigue caused by anaemia was described. All women reported heavy menstrual bleeding. Choices around pregnancy were limited by ‘medical pessimism’. Nevertheless, participants remained hopeful for the development of improved treatment options.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>People with GT face significant and often overlooked challenges. There is need for improved medical and psychological treatment and support, increased awareness of these needs amongst healthcare professionals, and research into developing comprehensive care models that address medical and psychosocial needs of people with GT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"30 6","pages":"1373-1382"},"PeriodicalIF":3.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hae.15126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the impact of the self-BAT screening tool on patient outcomes: Results of the let's talk period project 评估自我 BAT 筛查工具对患者治疗效果的影响:我们来谈谈 "项目的结果。
IF 3 2区 医学 Q2 HEMATOLOGY Pub Date : 2024-11-15 DOI: 10.1111/hae.15113
Laura McDonald, Julie Grabell, Jennifer Leung, Wilma Hopman, Paula James

Introduction

One of the many challenges in diagnosing bleeding disorders is distinguishing between normal and abnormal bleeding symptoms. Letstalkperiod.ca is an educational website that includes an online self-administered bleeding assessment tool (Self-BAT) which is a validated screening tool that enables patients to independently determine their bleeding scores (BS).

Aim

The aim of this study was to evaluate patient outcomes for those referred with an abnormal Self-BAT BS compared to those referred without the prior use of the Self-BAT.

Methods

This was a retrospective, observational study. After obtaining REB approval, chart review was performed for patients evaluated for a suspected bleeding disorder in a tertiary care centre between 2016 and 2023.

Results

351 patients (310 female) were identified for inclusion with a mean age of 41 years. Of these patients, 30 were referred for a positive/abnormal Self-BAT BS and the remainder were referred for other reasons. Patients referred for a positive Self-BAT BS required interventions for their bleeding symptoms more often (73.3% vs. 36.7%, p ≤ .001). Though they were not diagnosed with an inherited bleeding disorder more often (6.7% vs. 10.7%, p = .754), patients referred for a positive self-BAT were more likely to be diagnosed with a bleeding disorder when the definition was expanded to include bleeding disorder of unknown cause (56.7% vs. 31.9%, p = .008).

Conclusion

Results of this study suggest that the Self-BAT at letstalkperiod.ca can be a useful tool for patients and physicians to identify those needing referral to tertiary haematology clinics for evaluation and management of bleeding symptoms.

导言:诊断出血性疾病的诸多挑战之一是区分正常和异常出血症状。Letstalkperiod.ca是一个教育网站,其中包括一个在线自制出血评估工具(Self-BAT),这是一个经过验证的筛查工具,能让患者独立确定自己的出血评分(BS)。目的:本研究旨在评估Self-BAT BS异常的转诊患者与未使用Self-BAT的转诊患者的治疗效果:这是一项回顾性观察研究。在获得 REB 批准后,对 2016 年至 2023 年间在一家三级医疗中心接受疑似出血性疾病评估的患者进行了病历审查:共确定纳入 351 名患者(310 名女性),平均年龄为 41 岁。在这些患者中,30 人因自我 BAT BS 阳性/异常而转诊,其余患者因其他原因转诊。因 Self-BAT BS 阳性而转诊的患者需要对出血症状进行干预的比例更高(73.3% 对 36.7%,P ≤ .001)。虽然他们被诊断为遗传性出血性疾病的比例并不更高(6.7% vs. 10.7%,p = .754),但当自我BAT阳性转诊患者的定义扩大到包括原因不明的出血性疾病时,他们被诊断为出血性疾病的比例更高(56.7% vs. 31.9%,p = .008):本研究结果表明,letstalkperiod.ca网站上的自我BAT可以作为一种有用的工具,帮助患者和医生识别需要转诊到三级血液病诊所接受出血症状评估和治疗的患者。
{"title":"Evaluating the impact of the self-BAT screening tool on patient outcomes: Results of the let's talk period project","authors":"Laura McDonald,&nbsp;Julie Grabell,&nbsp;Jennifer Leung,&nbsp;Wilma Hopman,&nbsp;Paula James","doi":"10.1111/hae.15113","DOIUrl":"10.1111/hae.15113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>One of the many challenges in diagnosing bleeding disorders is distinguishing between normal and abnormal bleeding symptoms. Letstalkperiod.ca is an educational website that includes an online self-administered bleeding assessment tool (Self-BAT) which is a validated screening tool that enables patients to independently determine their bleeding scores (BS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this study was to evaluate patient outcomes for those referred with an abnormal Self-BAT BS compared to those referred without the prior use of the Self-BAT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective, observational study. After obtaining REB approval, chart review was performed for patients evaluated for a suspected bleeding disorder in a tertiary care centre between 2016 and 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>351 patients (310 female) were identified for inclusion with a mean age of 41 years. Of these patients, 30 were referred for a positive/abnormal Self-BAT BS and the remainder were referred for other reasons. Patients referred for a positive Self-BAT BS required interventions for their bleeding symptoms more often (73.3% vs. 36.7%, <i>p</i> ≤ .001). Though they were not diagnosed with an <i>inherited</i> bleeding disorder more often (6.7% vs. 10.7%, <i>p</i> = .754), patients referred for a positive self-BAT were more likely to be diagnosed with a bleeding disorder when the definition was expanded to include bleeding disorder of unknown cause (56.7% vs. 31.9%, <i>p</i> = .008).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Results of this study suggest that the Self-BAT at letstalkperiod.ca can be a useful tool for patients and physicians to identify those needing referral to tertiary haematology clinics for evaluation and management of bleeding symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"30 6","pages":"1400-1405"},"PeriodicalIF":3.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hae.15113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Unexpected pulmonary embolism in a giant haemophilia pelvic pseudotumor resection surgery: A case report and literature review. 巨型血友病盆腔假瘤切除手术中的意外肺栓塞:病例报告和文献综述。
IF 3 2区 医学 Q2 HEMATOLOGY Pub Date : 2024-11-14 DOI: 10.1111/hae.15118
Zhu Wei, Ren Miao, Feng Bin, Weng Xisheng
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引用次数: 0
Knee arthrodesis in treatment of haemophilic arthropathy of the knee. 治疗膝关节血友病的膝关节固定术。
IF 3 2区 医学 Q2 HEMATOLOGY Pub Date : 2024-11-14 DOI: 10.1111/hae.15117
Arman Vahabi, Elcil Kaya Biçer, Fahri Şahin, Kaan Kavaklı, Semih Aydoğdu
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引用次数: 0
The impact of emicizumab on the clinical validation of new therapies for haemophilia A. 埃米珠单抗对血友病 A 新疗法临床验证的影响。
IF 3 2区 医学 Q2 HEMATOLOGY Pub Date : 2024-11-08 DOI: 10.1111/hae.15112
Cedric Hermans, Catherine Lambert, Sébastien Lobet, Evelien Krumb, An Van Damme
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引用次数: 0
期刊
Haemophilia
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