Data di Pubblicazione:
2015
Citazione:
Rare bleeding disorders: diagnosis and treatment / R. Palla, F. Peyvandi, A.D.Shapiro. - In: BLOOD. - ISSN 1528-0020. - 125:13(2015 Mar 26), pp. 2052-2061. [10.1182/blood-2014-08-532820]
Abstract:
Despite the worldwide prevalence of rare bleeding disorders (RBDs), knowledge of these conditions and their management is suboptimal; health care professionals often have little diagnostic and treatment experience with variable access to diagnostic modalities required for accurate identification. Therefore, patients often experience morbidity and mortality due to delayed diagnosis. As RBDs represent a small potential commercial market, few, if any, specific therapies exist for these conditions. As a result, affected individuals commonly face delayed diagnosis, incomplete laboratory evaluation, and limited treatment options. Standardization and customization of coagulation assays, full genome sequencing, and global clotting assays will significantly improve diagnosis of patients with RBDs. In addition, new therapeutic modalities, both recombinant and plasma derived, are emerging, at least in developed countries. Registries and clinical trials have demonstrated decreased bleeding and improved outcomes when patients are appropriately diagnosed and properly treated. Expansion and harmonization of international registries has been initiated to correlate genotype, laboratory, and clinical phenotypes including bleeding severity to improve the diagnosis and therapeutic approach. This review focuses on the latest advances in our understanding, diagnosis, and treatment of RBDs.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
factor-XI deficiency; factor-VII deficiency; inherited coagulation disorders; fresh-frozen plasma; factor-V; surveillance system; replacement therapy; thrombin generation; British-committee; update
Elenco autori:
R. Palla, F. Peyvandi, A.D. Shapiro
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