Ciavarella N, Antoncecchi S, Ranieri P
Br J Haematol. 1984 Dec;58(4):641-8. doi: 10.1111/j.1365-2141.1984.tb06111.x.
We report our experience with polyelectrolyte-fractionated highly purified porcine factor VIII concentrate (Hyate:C). Porcine factor VIII concentrate was used to treat 14 haemorrhagic episodes including seven severe haemarthroses, three severe haematomata, two episodes of oral bleeding, one traumatic and the other after multiple dental extractions and two life-threatening intestinal haemorrhages. Altogether 60 infusions of Hyate:C were given to five haemophiliacs with inhibitors. At the time of the first infusion with porcine factor VIII the anti-human inhibitor level ranged from 60 to 2.5 modified Bethesda units/ml (MBU 4 h incubation). The porcine cross-reactivity of these inhibitors was 25.6% and 5.4% of the human inhibitor level in two patients and scarcely measurable in the other three patients. We injected an amount of porcine factor VIII concentrate corresponding to the calculated porcine neutralizing units plus the units required for haemostasis. The clinical efficacy was excellent and no adverse effects were encountered, apart from two episodes of mild pyrogenic reactions well controlled by hydrocortisone. The anamnestic antibody response against human factor VIII was of slight degree in all cases, while the porcine cross-reactivity showed no significant variation. Our results emphasize the role of porcine factor VIII in the treatment of haemophiliacs with inhibitors.
我们报告了使用聚电解质分级分离的高度纯化猪源凝血因子VIII浓缩物（Hyate:C）的经验。猪源凝血因子VIII浓缩物用于治疗14次出血事件，包括7次严重关节积血、3次严重血肿、2次口腔出血、1次外伤后出血和另1次多次拔牙后出血，以及2次危及生命的肠道出血。总共对5名有抑制剂的血友病患者输注了60次Hyate:C。首次输注猪源凝血因子VIII时，抗人抑制剂水平在60至2.5改良贝塞斯达单位/毫升（4小时孵育的MBU）之间。这些抑制剂对猪源的交叉反应性在两名患者中分别为人类抑制剂水平的25.6%和5.4%，在其他三名患者中几乎无法测量。我们注射了相当于计算出的猪源中和单位加上止血所需单位量的猪源凝血因子VIII浓缩物。临床疗效极佳，除了两例轻度热原反应经氢化可的松良好控制外，未出现不良反应。在所有病例中，针对人凝血因子VIII的回忆性抗体反应程度轻微，而猪源交叉反应性无显著变化。我们的结果强调了猪源凝血因子VIII在治疗有抑制剂的血友病患者中的作用。
