Hemophilia A is a congenital bleeding disorder caused by deficiency of factor VIII (FVIII) and is treated by replacement therapy with FVIII concentrate. Approximately 30% of people with severe hemophilia A develop neutralizing antibodies, called FVIII inhibitors, which interfere with the function of FVIII concentrates. The reason that some, but not all, people with severe hemophilia A develop inhibitors is incompletely understood. Understanding individual and environmental risk factors is important to be able to prevent and possibly treat inhibitors. This study will look at individual and treatment characteristics in babies with severe hemophilia A who have not yet received treatment with FVIII (called Previously Untreated Patients, or PUPS). Subjects in the study will be asked to provide diaries of treatments, medications, and illnesses. Treatment will be directed by the subjects' physician, but all subjects will receive Advate, a third-generation recombinant FVIII product. Subjects will have blood drawn for laboratory tests, which include studies of the immune system and genetic studies of the FVIII mutation, before and 7-9 days after the first treatment with FVIII, and 5 days (+/-2 days) after the 5th, 10th, 20th, 30th, 40th, and 50th days of treatment with FVIII (exposure days). The duration of the study will be first 50 treatments or 3 years, whichever comes first.
Study Type
OBSERVATIONAL
Enrollment
25
usual treatment as directed by treating physician
Emory University
Atlanta, Georgia, United States
Indiana Hemophilia and Thrombosis Center
Indianapolis, Indiana, United States
University of Kentucky
Lexington, Kentucky, United States
Tulane University
New Orleans, Louisiana, United States
Cornell University
New York, New York, United States
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States
Cincinnati Children's Hospital
Cincinnati, Ohio, United States
University of Oregon
Portland, Oregon, United States
Hemophilia Center of Western Pennsylvania
Pittsburgh, Pennsylvania, United States
North Texas Comprehensive Hemophilia Center
Dallas, Texas, United States
...and 7 more locations
Total number of FOXP3-positive T regulatory cells in the circulation
FoxP3(a protein involved in immune system responses)-positive T regulatory cells in the circulation will be compared before and after exposure to FVIII.
Time frame: 50 exposure days to FVIII or 3 years, whichever comes first
FVIII-specific T-cells
FVIII-specific T-cells will be compared before and after exposure to FVIII
Time frame: 50 exposure days to FVIII or 3 years, whichever comes first
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