Pub Date : 2025-11-01DOI: 10.1016/j.rpth.2025.103136
Madeline Young , Maria Teresa De Sancho
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Pub Date : 2025-11-01DOI: 10.1016/j.rpth.2025.103241
Jingyao Ma , Zhifa Wang , Juntao Ouyang , Zheyan Lin , Lingling Fu , Zhenping Chen , Yan Liu , Lijuan Wang , Xi Lin , Xiaoling Cheng , Yu Hu , Shuyue Dong , Jinxi Meng , Jie Ma , Runhui Wu
Background
Immune thrombocytopenia (ITP) in children is an autoimmune disorder in which a significant subset develops persistent or chronic disease requiring second-line therapies, yet the optimal sequencing of agents such as rituximab (RTX) and eltrombopag (ELT) to achieve sustained remission off-treatment remains (SRoT) undefined.
Objectives
This study assessed whether RTX-first sequential therapy outperforms upfront ELT monotherapy in achieving durable remission for pediatric persistent/chronic ITP (p/cITP) after first-line failure.
Methods
This nonrandomized multicenter prospective cohort study enrolled 55 children (April 2020 to July 2023) with refractory p/cITP until first-line therapy. They were assigned to RTX-first (RfG, n = 35: single RTX dose, then ELT for nonresponders) or ELT monotherapy (ELT-first group [EfG], n = 20) groups, with 12-month follow-up. Primary endpoints were SRoT and treatment duration (TD), and secondary endpoints were response rate and safety. The study is registered at ChiCTR2100048162.
Results
Among the 55 enrolled children (RfG = 35, EfG = 20), RfG had superior SRoT (30%; 95% CI, 15.6%-48.7%) than ELT-monotherapy group (0%; 95% CI, 0%-18.7%; P = .016), although 12-month remission rates were comparable (84.8% vs 87.5%; P = .804). RfG had a shorter TD (median 18 vs 34 weeks; P = .009), even in severe cases (baseline platelets 20 ×109/L vs 29 ×109/L; P = .034). Early ELT (≤96 days) in RfG nonresponders improved outcomes (P = .024). Both treatments had favorable safety (grade 1-2 adverse events, <15%).
Conclusions
RTX-first treatment yields a better SRoT and shorter TD than ELT monotherapy for pediatric p/cITP, with comparable remission and safety.
背景:儿童免疫性血小板减少症(ITP)是一种自身免疫性疾病,其中一个重要的亚群会发展为持续性或慢性疾病,需要二线治疗,但利妥昔单抗(RTX)和伊曲博帕(ELT)等药物的最佳序列仍未确定,以实现持续的治疗缓解(SRoT)。目的:本研究评估在一线治疗失败后,儿童持续性/慢性ITP (p/cITP)的持续缓解方面,rtx优先序贯治疗是否优于前期ELT单药治疗。方法:这项非随机多中心前瞻性队列研究纳入了55名顽固性p/ ctp患儿(2020年4月至2023年7月),直至一线治疗。他们被分为RTX优先组(RfG, n = 35:单次RTX剂量,无反应者再服用ELT)或ELT单药治疗组(ELT优先组[EfG], n = 20),随访12个月。主要终点是SRoT和治疗时间(TD),次要终点是有效率和安全性。这项研究的注册号码是ChiCTR2100048162。结果在55名入组儿童(RfG = 35, EfG = 20)中,RfG组的SRoT (30%, 95% CI, 15.6%-48.7%)优于elt单药治疗组(0%,95% CI, 0%-18.7%, P = 0.016),尽管12个月缓解率相当(84.8% vs 87.5%, P = 0.804)。RfG的TD较短(中位18周vs 34周;P = 0.009),即使在严重的病例中(基线血小板20 ×109/L vs 29 ×109/L; P = 0.034)。RfG无应答者的早期ELT(≤96天)改善了结果(P = 0.024)。两种治疗均具有良好的安全性(1-2级不良事件,15%)。结论srtx优先治疗儿童p/ ctp的疗效优于ELT单药治疗,且缓解期和安全性相当。
{"title":"Rituximab-first versus eltrombopag monotherapy in pediatric persistent/chronic immune refractory thrombocytopenia after first-line therapy: a prospective multicenter cohort study","authors":"Jingyao Ma , Zhifa Wang , Juntao Ouyang , Zheyan Lin , Lingling Fu , Zhenping Chen , Yan Liu , Lijuan Wang , Xi Lin , Xiaoling Cheng , Yu Hu , Shuyue Dong , Jinxi Meng , Jie Ma , Runhui Wu","doi":"10.1016/j.rpth.2025.103241","DOIUrl":"10.1016/j.rpth.2025.103241","url":null,"abstract":"<div><h3>Background</h3><div>Immune thrombocytopenia (ITP) in children is an autoimmune disorder in which a significant subset develops persistent or chronic disease requiring second-line therapies, yet the optimal sequencing of agents such as rituximab (RTX) and eltrombopag (ELT) to achieve sustained remission off-treatment remains (SRoT) undefined.</div></div><div><h3>Objectives</h3><div>This study assessed whether RTX-first sequential therapy outperforms upfront ELT monotherapy in achieving durable remission for pediatric persistent/chronic ITP (p/cITP) after first-line failure.</div></div><div><h3>Methods</h3><div>This nonrandomized multicenter prospective cohort study enrolled 55 children (April 2020 to July 2023) with refractory p/cITP until first-line therapy. They were assigned to RTX-first (RfG, <em>n</em> = 35: single RTX dose, then ELT for nonresponders) or ELT monotherapy (ELT-first group [EfG], <em>n</em> = 20) groups, with 12-month follow-up. Primary endpoints were SRoT and treatment duration (TD), and secondary endpoints were response rate and safety. The study is registered at ChiCTR2100048162.</div></div><div><h3>Results</h3><div>Among the 55 enrolled children (RfG = 35, EfG = 20), RfG had superior SRoT (30%; 95% CI, 15.6%-48.7%) than ELT-monotherapy group (0%; 95% CI, 0%-18.7%; <em>P</em> = .016), although 12-month remission rates were comparable (84.8% vs 87.5%; <em>P</em> = .804). RfG had a shorter TD (median 18 vs 34 weeks; <em>P</em> = .009), even in severe cases (baseline platelets 20 ×10<sup>9</sup>/L vs 29 ×10<sup>9</sup>/L; <em>P</em> = .034). Early ELT (≤96 days) in RfG nonresponders improved outcomes (<em>P</em> = .024). Both treatments had favorable safety (grade 1-2 adverse events, <15%).</div></div><div><h3>Conclusions</h3><div>RTX-first treatment yields a better SRoT and shorter TD than ELT monotherapy for pediatric p/cITP, with comparable remission and safety.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 8","pages":"Article 103241"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Recurrent joint bleeding in people with hemophilia A (PwHA) can cause hemophilic arthropathy, resulting in limited movement and chronic pain. Emicizumab is a bispecific monoclonal antibody bridging activated factor (F)IX and FX to substitute for deficient activated FVIII in PwHA, thereby improving hemostasis.
Objectives
This 3-year interim analysis of the ongoing, open-label, phase IV AOZORA study (jRCT1080224629) analyzes medium-term safety and joint health in pediatric PwHA without FVIII inhibitors receiving emicizumab.
Methods
PwHA aged <12 years with severe hemophilia A without FVIII inhibitors were eligible. Participants entered AOZORA as emicizumab-naïve or having previously initiated emicizumab during the HOHOEMI study. Endpoints included safety, and joint health, as assessed by magnetic resonance imaging and Hemophilia Joint Health Score (HJHS). Participants will receive emicizumab for 6 years.
Results
A total of 30 male PwHA were enrolled. Data cutoff was the last day of week 145 for each participant. Median (range) age was 4.2 (0.7-11.1) years, and 27 of the 30 (90.0%) had received prior FVIII prophylaxis. The emicizumab safety profile was confirmed. No thrombotic events/microangiopathies occurred. All joints with synovial hypertrophy and hemosiderin resolved or improved by week 145. HJHS remained at 0 from week 1 to week 145 for 18 (66.7%) participants; overall, there was no worsening trend in HJHS over time. Model-based annualized bleeding rate (95% CI) for treated bleeds was 3.6 (2.04-6.46) prior to emicizumab and 0.8 (0.47-1.22) after receiving emicizumab.
Conclusion
Emicizumab is well tolerated and appears to maintain or improve joint health in pediatric PwHA.
{"title":"AOZORA study: 3-year interim analysis of safety and joint health in pediatric people with hemophilia A receiving emicizumab prophylaxis","authors":"Midori Shima , Hideyuki Takedani , Kaoru Kitsukawa , Masashi Taki , Akira Ishiguro , Chiai Nagae , Azusa Nagao , Daisuke Nosaka , Yui Kyogoku , Hiroki Oki , Keisuke Iwasaki , Keiji Nogami","doi":"10.1016/j.rpth.2025.103228","DOIUrl":"10.1016/j.rpth.2025.103228","url":null,"abstract":"<div><h3>Background</h3><div>Recurrent joint bleeding in people with hemophilia A (PwHA) can cause hemophilic arthropathy, resulting in limited movement and chronic pain. Emicizumab is a bispecific monoclonal antibody bridging activated factor (F)IX and FX to substitute for deficient activated FVIII in PwHA, thereby improving hemostasis.</div></div><div><h3>Objectives</h3><div>This 3-year interim analysis of the ongoing, open-label, phase IV AOZORA study (jRCT1080224629) analyzes medium-term safety and joint health in pediatric PwHA without FVIII inhibitors receiving emicizumab.</div></div><div><h3>Methods</h3><div>PwHA aged <12 years with severe hemophilia A without FVIII inhibitors were eligible. Participants entered AOZORA as emicizumab-naïve or having previously initiated emicizumab during the HOHOEMI study. Endpoints included safety, and joint health, as assessed by magnetic resonance imaging and Hemophilia Joint Health Score (HJHS). Participants will receive emicizumab for 6 years.</div></div><div><h3>Results</h3><div>A total of 30 male PwHA were enrolled. Data cutoff was the last day of week 145 for each participant. Median (range) age was 4.2 (0.7-11.1) years, and 27 of the 30 (90.0%) had received prior FVIII prophylaxis. The emicizumab safety profile was confirmed. No thrombotic events/microangiopathies occurred. All joints with synovial hypertrophy and hemosiderin resolved or improved by week 145. HJHS remained at 0 from week 1 to week 145 for 18 (66.7%) participants; overall, there was no worsening trend in HJHS over time. Model-based annualized bleeding rate (95% CI) for treated bleeds was 3.6 (2.04-6.46) prior to emicizumab and 0.8 (0.47-1.22) after receiving emicizumab.</div></div><div><h3>Conclusion</h3><div>Emicizumab is well tolerated and appears to maintain or improve joint health in pediatric PwHA.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 8","pages":"Article 103228"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.rpth.2025.103257
Jian-Yue Yang, Li-Li Li, Su-Zhen Fu
Background
Sepsis is a life-threatening condition characterized by organ dysfunction caused by a dysregulated host response to infection. Its associated coagulopathy, known as sepsis-induced coagulopathy (SIC), significantly increases mortality risk. The pan-immune-inflammation value (PIV), a composite biomarker reflecting systemic immune and inflammatory status, has been linked to prognosis in various diseases.
Objectives
This study aimed to evaluate the prognostic significance of PIV in patients with SIC and to develop predictive models accordingly.
Methods
This retrospective study utilized data from the Medical Information Mart for Intensive Care IV database and included 4554 patients diagnosed with sepsis. Patients were stratified into high- and low-PIV groups based on the median PIV, and clinical characteristics were compared between groups. Kaplan–Meier survival analysis and Cox regression were employed to assess the association between PIV and patient outcomes. Least absolute shrinkage and selection operator regression was used to identify key variables for constructing a nomogram model. Additionally, machine learning algorithms, including random forest, were applied to build and validate predictive models.
Results
Patients in the high-PIV group had significantly higher 30-day and 90-day mortality rates. Kaplan–Meier analysis showed that patients with lower PIVs had markedly better survival, and a nonlinear positive correlation was observed between PIV and mortality risk. Least absolute shrinkage and selection operator regression identified 8 key variables, including Acute Physiology Score III, lactate, red cell distribution width, mean corpuscular volume, acute kidney injury, and continuous renal replacement therapy. The nomogram based on these variables achieved areas under the receiver operating characteristic curve of 0.84 and 0.87 in the training and validation cohorts, respectively. Among machine learning models, the random forest algorithm exhibited the best predictive performance, with areas under the curve of 0.837 and 0.947 in the training and validation sets, respectively. External validation using a real-world cohort from Xingtai People’s Hospital further confirmed the association between elevated PIV and increased mortality and SIC, with consistent survival trends and nonlinear patterns observed in both Kaplan–Meier and restricted cubic spline analyses.
Conclusion
To our knowledge, this study is the first to incorporate PIV into the prognostic assessment of patients with SIC. The development of a visual nomogram and machine learning-based models provides clinicians with practical tools for early identification of patients at high risk for SIC, potentially aiding in the optimization of treatment strategies.
{"title":"Prognostic value of the pan-immune-inflammation value for mortality in sepsis-induced coagulopathy: a Medical Information Mart for Intensive Care study","authors":"Jian-Yue Yang, Li-Li Li, Su-Zhen Fu","doi":"10.1016/j.rpth.2025.103257","DOIUrl":"10.1016/j.rpth.2025.103257","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis is a life-threatening condition characterized by organ dysfunction caused by a dysregulated host response to infection. Its associated coagulopathy, known as sepsis-induced coagulopathy (SIC), significantly increases mortality risk. The pan-immune-inflammation value (PIV), a composite biomarker reflecting systemic immune and inflammatory status, has been linked to prognosis in various diseases.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the prognostic significance of PIV in patients with SIC and to develop predictive models accordingly.</div></div><div><h3>Methods</h3><div>This retrospective study utilized data from the Medical Information Mart for Intensive Care IV database and included 4554 patients diagnosed with sepsis. Patients were stratified into high- and low-PIV groups based on the median PIV, and clinical characteristics were compared between groups. Kaplan–Meier survival analysis and Cox regression were employed to assess the association between PIV and patient outcomes. Least absolute shrinkage and selection operator regression was used to identify key variables for constructing a nomogram model. Additionally, machine learning algorithms, including random forest, were applied to build and validate predictive models.</div></div><div><h3>Results</h3><div>Patients in the high-PIV group had significantly higher 30-day and 90-day mortality rates. Kaplan–Meier analysis showed that patients with lower PIVs had markedly better survival, and a nonlinear positive correlation was observed between PIV and mortality risk. Least absolute shrinkage and selection operator regression identified 8 key variables, including Acute Physiology Score III, lactate, red cell distribution width, mean corpuscular volume, acute kidney injury, and continuous renal replacement therapy. The nomogram based on these variables achieved areas under the receiver operating characteristic curve of 0.84 and 0.87 in the training and validation cohorts, respectively. Among machine learning models, the random forest algorithm exhibited the best predictive performance, with areas under the curve of 0.837 and 0.947 in the training and validation sets, respectively. External validation using a real-world cohort from Xingtai People’s Hospital further confirmed the association between elevated PIV and increased mortality and SIC, with consistent survival trends and nonlinear patterns observed in both Kaplan–Meier and restricted cubic spline analyses.</div></div><div><h3>Conclusion</h3><div>To our knowledge, this study is the first to incorporate PIV into the prognostic assessment of patients with SIC. The development of a visual nomogram and machine learning-based models provides clinicians with practical tools for early identification of patients at high risk for SIC, potentially aiding in the optimization of treatment strategies.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 8","pages":"Article 103257"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.rpth.2025.103240
Aman Goyal , Humza Saeed , Samia Aziz Sulaiman , Muhammad Khubaib Arshad , Kevin Michael Alexander , Sripal Bangalore , Liana K. Billings , Alfonso J. Tafur , Manan Pareek , Gregory Piazza , Arman Qamar
Background
Obesity increases the risk of pulmonary embolism (PE) through multiple mechanisms.
Objectives
This study examined mortality trends in patients with coexisting PE and obesity.
Methods
We analyzed the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database for individuals aged 25 years and older who died between 1999 and 2020 from concurrent PE and obesity. Temporal trends and age-adjusted mortality rates (AAMRs) were assessed using Joinpoint regression software. Annual percent changes (APCs), average annual percentage change differences, and 95% CIs were calculated, with statistical significance set at P < .05.
Results
From 1999 to 2020, the AAMR for PE with obesity increased from 5.1 (95% CI, 4.7-5.4) to 13.9 (95% CI, 13.4-14.4) per 1,000,000. The AAMR rose significantly from 1999 to 2018 (APC, 3.45; 95% CI, 2.65-4.01; P = .005), followed by a sharper increase from 2018 to 2020 (APC, 16.28; 95% CI, 6.24-21.22; P < .001). Women consistently had higher AAMRs than men (8.8; 95% CI, 8.6-8.9; vs 6.5; 95% CI, 6.4-6.6). Among age groups, middle-aged adults had the highest AAMR (10; 95% CI, 9.8-10.1), while among the ethnoracial groups, non-Hispanic Black individuals had the highest AAMR (16.8; 95% CI, 16.5-17.2). Residents of nonmetropolitan areas had higher AAMRs than those in metropolitan areas (8.9; 95% CI, 8.7-9.1; vs 7.5; 95% CI, 7.4-7.6). The increase in AAMR was significantly greater for PE with obesity compared with PE alone (average annual percentage change difference, 3.61; 95% CI, 2.91-4.32; P < .001).
Conclusions
The analysis reveals a significant rise in mortality from concurrent PE and obesity, with higher rates observed in women, middle-aged adults, non-Hispanic Black individuals, and residents of nonmetropolitan areas. These findings highlight the need for targeted interventions in these high-risk groups.
背景:肥胖通过多种机制增加肺栓塞(PE)的风险。目的:本研究探讨PE合并肥胖患者的死亡率趋势。方法:我们分析了美国疾病控制与预防中心流行病学研究数据库的广泛在线数据,其中包括1999年至2020年期间因PE和肥胖同时死亡的25岁及以上的个体。使用Joinpoint回归软件评估时间趋势和年龄调整死亡率(AAMRs)。计算年变化百分数(APCs)、平均年变化百分数差异和95% ci, P <; 0.05为统计学意义。结果1999年至2020年,PE合并肥胖的AAMR从5.1 (95% CI, 4.7-5.4) / 100万增加到13.9 (95% CI, 13.4-14.4) / 100万。从1999年到2018年,AAMR显著上升(APC, 3.45; 95% CI, 2.65-4.01; P = 0.005),随后从2018年到2020年急剧上升(APC, 16.28; 95% CI, 6.24-21.22; P < 0.001)。女性的aamr始终高于男性(8.8;95% CI, 8.6-8.9; vs . 6.5; 95% CI, 6.4-6.6)。在不同年龄组中,中年人的AAMR最高(10;95% CI, 9.8-10.1),而在不同种族中,非西班牙裔黑人的AAMR最高(16.8;95% CI, 16.5-17.2)。非大都市区居民的aamr高于大都市区居民(8.9;95% CI, 8.7-9.1; vs . 7.5; 95% CI, 7.4-7.6)。与单独PE相比,PE合并肥胖的AAMR增加明显更大(平均年百分比变化差为3.61;95% CI, 2.91-4.32; P < 0.001)。结论:分析显示,PE和肥胖并发的死亡率显著上升,在女性、中年人、非西班牙裔黑人和非大都市地区的居民中观察到更高的死亡率。这些发现强调了对这些高危人群进行有针对性干预的必要性。
{"title":"Disparities and trends in pulmonary embolism mortality with and without obesity: a nationwide US analysis","authors":"Aman Goyal , Humza Saeed , Samia Aziz Sulaiman , Muhammad Khubaib Arshad , Kevin Michael Alexander , Sripal Bangalore , Liana K. Billings , Alfonso J. Tafur , Manan Pareek , Gregory Piazza , Arman Qamar","doi":"10.1016/j.rpth.2025.103240","DOIUrl":"10.1016/j.rpth.2025.103240","url":null,"abstract":"<div><h3>Background</h3><div>Obesity increases the risk of pulmonary embolism (PE) through multiple mechanisms.</div></div><div><h3>Objectives</h3><div>This study examined mortality trends in patients with coexisting PE and obesity.</div></div><div><h3>Methods</h3><div>We analyzed the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database for individuals aged 25 years and older who died between 1999 and 2020 from concurrent PE and obesity. Temporal trends and age-adjusted mortality rates (AAMRs) were assessed using Joinpoint regression software. Annual percent changes (APCs), average annual percentage change differences, and 95% CIs were calculated, with statistical significance set at <em>P</em> < .05.</div></div><div><h3>Results</h3><div>From 1999 to 2020, the AAMR for PE with obesity increased from 5.1 (95% CI, 4.7-5.4) to 13.9 (95% CI, 13.4-14.4) per 1,000,000. The AAMR rose significantly from 1999 to 2018 (APC, 3.45; 95% CI, 2.65-4.01; <em>P</em> = .005), followed by a sharper increase from 2018 to 2020 (APC, 16.28; 95% CI, 6.24-21.22; <em>P</em> < .001). Women consistently had higher AAMRs than men (8.8; 95% CI, 8.6-8.9; vs 6.5; 95% CI, 6.4-6.6). Among age groups, middle-aged adults had the highest AAMR (10; 95% CI, 9.8-10.1), while among the ethnoracial groups, non-Hispanic Black individuals had the highest AAMR (16.8; 95% CI, 16.5-17.2). Residents of nonmetropolitan areas had higher AAMRs than those in metropolitan areas (8.9; 95% CI, 8.7-9.1; vs 7.5; 95% CI, 7.4-7.6). The increase in AAMR was significantly greater for PE with obesity compared with PE alone (average annual percentage change difference, 3.61; 95% CI, 2.91-4.32; <em>P</em> < .001).</div></div><div><h3>Conclusions</h3><div>The analysis reveals a significant rise in mortality from concurrent PE and obesity, with higher rates observed in women, middle-aged adults, non-Hispanic Black individuals, and residents of nonmetropolitan areas. These findings highlight the need for targeted interventions in these high-risk groups.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 8","pages":"Article 103240"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.rpth.2025.103239
Elleke van Heerwaarde , Annick de Moor , Albert Huisman , Rolf Urbanus , Idske Kremer Hovinga , Roger Schutgens , Thrombocytopathy in the Netherlands (TiN) study group
Background
δ-storage pool disease (δ-SPD) involves various platelet disorders due to deficient or reduced secretion of dense granules, causing increased bleeding tendency, particularly during surgery and delivery. The optimal treatment to prevent bleeding in δ-SPD is unknown.
Objectives
To evaluate the efficacy of preventive treatment in a cohort of patients with δ-SPD.
Methods
In a single-center study, we retrospectively reviewed the medical files of δ-SPD patients diagnosed between 2016 and 2024. Data included invasive diagnostic procedures, surgeries (minor/major), and deliveries (vaginal/cesarean section) before and after diagnosis. Diagnosis was confirmed by platelet adenosine diphosphate levels (<1.4 μmol/1011 platelets). Bleeding complications were defined according to the International Society on Thrombosis and Haemostasis bleeding scale. Data on treatment and platelet transfusions were documented.
Results
Thirty-eight patients (mean age, 35.6 years; range, 0-67; 63.2% female) were included. The average adenosine diphosphate level was 0.82 μmol/1011 platelets (range, 0.2-1.4). A total of 161 interventions and deliveries were analyzed. The bleeding rate was dependent on the timing of diagnosis (51.5% before δ-SPD diagnosis and 16.8% after; P < .001) and on the use of preventive treatment (45.8% without and 17.9% with; P < .001). A total of 145 interventions were analyzed, including 63 minor and 82 major. Of these, 43/145 (29.7%) were complicated by bleeding (39 minor bleeds and 4 major bleeds). Sixteen deliveries were analyzed. Among 10 vaginal deliveries, 9 had postpartum hemorrhage, of whom 6 had no prophylaxis. All 6 cesarean sections received prophylactic platelet transfusion; no bleeding occurred.
Conclusion
We observed a high perioperative/peripartum bleeding rate in patients with δ-SPD. This decreased significantly after a correct diagnosis. In addition, bleeding rates were significantly lower among patients who received preventive treatment before the procedure.
{"title":"High bleeding rates in δ-storage pool disease during surgeries and deliveries","authors":"Elleke van Heerwaarde , Annick de Moor , Albert Huisman , Rolf Urbanus , Idske Kremer Hovinga , Roger Schutgens , Thrombocytopathy in the Netherlands (TiN) study group","doi":"10.1016/j.rpth.2025.103239","DOIUrl":"10.1016/j.rpth.2025.103239","url":null,"abstract":"<div><h3>Background</h3><div>δ-storage pool disease (δ-SPD) involves various platelet disorders due to deficient or reduced secretion of dense granules, causing increased bleeding tendency, particularly during surgery and delivery. The optimal treatment to prevent bleeding in δ-SPD is unknown.</div></div><div><h3>Objectives</h3><div>To evaluate the efficacy of preventive treatment in a cohort of patients with δ-SPD.</div></div><div><h3>Methods</h3><div>In a single-center study, we retrospectively reviewed the medical files of δ-SPD patients diagnosed between 2016 and 2024. Data included invasive diagnostic procedures, surgeries (minor/major), and deliveries (vaginal/cesarean section) before and after diagnosis. Diagnosis was confirmed by platelet adenosine diphosphate levels (<1.4 μmol/10<sup>11</sup> platelets). Bleeding complications were defined according to the International Society on Thrombosis and Haemostasis bleeding scale. Data on treatment and platelet transfusions were documented.</div></div><div><h3>Results</h3><div>Thirty-eight patients (mean age, 35.6 years; range, 0-67; 63.2% female) were included. The average adenosine diphosphate level was 0.82 μmol/10<sup>11</sup> platelets (range, 0.2-1.4). A total of 161 interventions and deliveries were analyzed. The bleeding rate was dependent on the timing of diagnosis (51.5% before δ-SPD diagnosis and 16.8% after; <em>P</em> < .001) and on the use of preventive treatment (45.8% without and 17.9% with; <em>P</em> < .001). A total of 145 interventions were analyzed, including 63 minor and 82 major. Of these, 43/145 (29.7%) were complicated by bleeding (39 minor bleeds and 4 major bleeds). Sixteen deliveries were analyzed. Among 10 vaginal deliveries, 9 had postpartum hemorrhage, of whom 6 had no prophylaxis. All 6 cesarean sections received prophylactic platelet transfusion; no bleeding occurred.</div></div><div><h3>Conclusion</h3><div>We observed a high perioperative/peripartum bleeding rate in patients with δ-SPD. This decreased significantly after a correct diagnosis. In addition, bleeding rates were significantly lower among patients who received preventive treatment before the procedure.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 8","pages":"Article 103239"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145577683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Do combined oral contraceptives induce formation of tissue factor?","authors":"Søren Risom Kristensen , Jette Nybo , Jesper Strandberg","doi":"10.1016/j.rpth.2025.103260","DOIUrl":"10.1016/j.rpth.2025.103260","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 8","pages":"Article 103260"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.rpth.2025.103071
Roberto Aiolfi , Antonella Zampolli , Miriam Hauer-Jensen , Jose A. Fernandez , Angel Gandarilla , Julia C. Mosnier , Amanda J. Roberts , Juan Carlos de la Torre , Laurent O. Mosnier , Xiao Xu
{"title":"HTRS2025.P1.51 SARS-CoV-2 infection in a mouse model of Long COVID shows enhanced thrombotic susceptibility, endotheliopathy, and abnormal cognitive behavior for up to 5 months post-infections","authors":"Roberto Aiolfi , Antonella Zampolli , Miriam Hauer-Jensen , Jose A. Fernandez , Angel Gandarilla , Julia C. Mosnier , Amanda J. Roberts , Juan Carlos de la Torre , Laurent O. Mosnier , Xiao Xu","doi":"10.1016/j.rpth.2025.103071","DOIUrl":"10.1016/j.rpth.2025.103071","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 103071"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145711785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.rpth.2025.103074
Adam Cuker , Madison Snyder , Kaan Kavakli , Robert Klamroth , Lisa J. Wilcox , Delphine Agathon , Pascal Klaus , Pengling Sun , Frank Plonski
{"title":"HTRS2025.P2.54 Corticosteroid Experience With Fidanacogene Elaparvovec in Adults With Moderately Severe or Severe Hemophilia B: Results From the Phase 3 BENEGENE-2 Gene Therapy Trial","authors":"Adam Cuker , Madison Snyder , Kaan Kavakli , Robert Klamroth , Lisa J. Wilcox , Delphine Agathon , Pascal Klaus , Pengling Sun , Frank Plonski","doi":"10.1016/j.rpth.2025.103074","DOIUrl":"10.1016/j.rpth.2025.103074","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 103074"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145711788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"HTRS2025.P2.61 Post-operative outcomes in adult patients with Hemophilia A using efanesoctocog alfa","authors":"Anya Parekh , Cody Angerman , Marvin Sanchez , Anjlee Mahajan , Adam Giermasz","doi":"10.1016/j.rpth.2025.103081","DOIUrl":"10.1016/j.rpth.2025.103081","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 103081"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145711795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}