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A patient with severe hemophilia A was given long-term prophylactic treatment with an aminoacetic acid-precipitated preparation of human factor VIII (antihemophilic factor AHF). Dosage was based on units of AHF per kilogram of body weight required to maintain AHF levels between 80% and 100% of normal. Weekly intravenous infusions produced predictable AHF levels. Response to the concentrate was prompt. Hemostasis was achieved following two episodes of severe, spontaneous, intracerebral and gastrointestinal hemorrhage. Despite extensive bruising of the patient's entire body after an automobile accident, no hematomas developed. The preparation was well tolerated with no changes in pulse rate or blood pressure. Neither hyperfibrinogenemia nor hypervolemia occurred. With the evidence provided by this case, and the availability of AHF concentrates for simple office or outpatient treatment, prophylaxis of severe hemophilia now appears feasible.
Edward Shanbrom (Mon,) studied this question.
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