Laurian Y, Girma J P, Lambert T, Meyer D, Larrieu M J
Blood. 1984 Feb;63(2):457-62.
An activated prothrombin complex concentrate (Autoplex) was infused for the treatment of 102 bleeding episodes in 18 hemophilia A patients with antibody to factor VIII who were previously known as high responders. Among 95 bleeding episodes treated with a single infusion of the concentrate [43-107 factor VIII correcting units (FECU)/kg], only 1 anamnestic response was observed. On the contrary, a significant rise in antibody titer occurred following 2 of 4 double (at 8-12 hr interval) and all 3 multiple (over 3-10 days) infusions of Autoplex. The occurrence of immune responses may be explained by the presence of factor VIII coagulant antigen (VIII:CAg) in the 26 batches of Autoplex tested by two-site immunoradiometric assay (10-36 U/vial). The anamnestic response was not correlated to the batch used nor to the amount (0.6-7.8 U/kg/day) of VIII:CAg infused per day. However, exposure to the concentrate over several days appeared to be the major predisposing factor for an immune response.
使用活化凝血酶原复合物浓缩剂（Autoplex）对18名既往被认为是高反应者的甲型血友病且伴有抗凝血因子VIII抗体的患者的102次出血发作进行治疗。在95次单次输注该浓缩剂[43 - 107凝血因子VIII校正单位（FECU）/千克]治疗的出血发作中，仅观察到1次回忆反应。相反，在4次双次输注（间隔8 - 12小时）中的2次以及所有3次多次输注（超过3 - 10天）Autoplex后，抗体滴度显著升高。免疫反应的发生可能是由于通过双位点免疫放射分析检测的26批Autoplex中存在凝血因子VIII凝血抗原（VIII:CAg）（10 - 36 U/瓶）。回忆反应与所使用的批次以及每日输注的VIII:CAg量（0.6 - 7.8 U/千克/天）均无关。然而，数天内接触该浓缩剂似乎是免疫反应的主要诱发因素。
