PROFILE OF PERIPHERAL BLOOD CELL INFLAMMATORY INDICES IN HEMOPHILIA A PATIENTS ON INHIBITOR THERAPY

Objective: The present study was designed to investigate the effect of Emicizumab on the peripheral blood cell systemic inflammatory markers of haemophilia A patients with inhibitors. Materials and Methods: This was a quasi-experimental study involving 16 Haemophilia A patients with inhibitors and 16 apparently healthy-age and gender matched controls. Inhibitor screening and titer were determined by the Nijmegen-Bethesda Assay. 3mg/kg b.wt Emicizumab (Remicade, Schering-Plough, Medical Products Trade A.S., Istanbul, Turkey) were administered to the haemophilia A patients and haemogram counts for both subjects and controls were determined using automated hematology analyzer (Mindray 530 BC, China). Data was analyzed using statistical package for social science version 25 (IBM statistics Armok, NY, USA) and presented as mean ± SD with p˂0.05 considered significant. Results: Patients showed significant increase in the parameters involving the Neutrophil/lymphocyte ratio (37±5.3), monocyte/lymphocyte ratio (33±3.4), platelet/lymphocyte ratio (38±8.6), basophil/monocyte ratio (5.6±1.5) and eosinophil/lymphocyte ratios (42.6±4.4) for the hemophilia A patients on Emicizumab therapy at week4 compared to the controls (14±2.9, 8.8±2.3, 13±2.5, 0.37±0.1, 2.6±1.4 respectively). However, there were no significant differences at the week 12 on continued Emicizumab therapy (13.7±2.8, 9.2±3.0, 12.6±2.0, 7.2±1.3, 0.45±1.3 respectively).Conclusion: Reduction in systemic inflammation may be a mechanism for control of bleeding in hemophilia on Emicizumab therapy.