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Advantages, disadvantages and optimization of one-stage and chromogenic factor activity assays in haemophilia A and B

Adcock, D. M. ; Strandberg, K. LU ; Shima, M. and Marlar, R. A. (2018) In International Journal of Laboratory Hematology 40(6). p.621-629
Abstract

Haemophilia A and B diagnosis and disease severity classification are determined on the basis of results from factor VIII (FVIII) and factor FIX (FIX) activity assays, respectively. These assays are also used for potency labelling, postinfusion monitoring of factor replacement products and testing for FVIII/FIX inhibitors. This review focuses on activated partial thromboplastin time (APTT)-based one-stage assays (OSAs) and two-stage chromogenic substrate assays (CSAs). Currently, there is considerable inter-laboratory variability in the results obtained using OSAs, which can be intensified in a reagent-specific manner by the presence of the new modified recombinant factor replacement products that are entering the market. Furthermore,... (More)

Haemophilia A and B diagnosis and disease severity classification are determined on the basis of results from factor VIII (FVIII) and factor FIX (FIX) activity assays, respectively. These assays are also used for potency labelling, postinfusion monitoring of factor replacement products and testing for FVIII/FIX inhibitors. This review focuses on activated partial thromboplastin time (APTT)-based one-stage assays (OSAs) and two-stage chromogenic substrate assays (CSAs). Currently, there is considerable inter-laboratory variability in the results obtained using OSAs, which can be intensified in a reagent-specific manner by the presence of the new modified recombinant factor replacement products that are entering the market. Furthermore, the use of CSAs, which tend to show less variability, especially with the new modified products, is recommended in a number of clinical scenarios. Clinical laboratories may, therefore, need to establish CSAs for routine use. In this review, we aim to improve understanding and help establish best practices by describing the methodology behind OSAs and CSAs and highlighting assay advantages and limitations. We argue that there can be value in offering both assay methodologies in clinical laboratories that contribute to the care of patients with haemophilia A or B. Educating both laboratory scientists and clinicians about the strengths and weaknesses of each type of assay will help to establish the necessary dialogue that is key to ensuring not only that the appropriate assays are used in the right clinical situations, but also that the results are interpreted correctly.

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author
; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Chromogenic assay, Clinical laboratory, Factor activity assay, Haemophilia, One-stage assay
in
International Journal of Laboratory Hematology
volume
40
issue
6
pages
621 - 629
publisher
Wiley-Blackwell
external identifiers
  • pmid:29979821
  • scopus:85050387500
ISSN
1751-5521
DOI
10.1111/ijlh.12877
language
English
LU publication?
no
id
bf8710ff-e749-49a5-ac4f-ea905f517b4e
date added to LUP
2018-10-01 09:23:00
date last changed
2024-07-09 22:19:37
@article{bf8710ff-e749-49a5-ac4f-ea905f517b4e,
  abstract     = {{<p>Haemophilia A and B diagnosis and disease severity classification are determined on the basis of results from factor VIII (FVIII) and factor FIX (FIX) activity assays, respectively. These assays are also used for potency labelling, postinfusion monitoring of factor replacement products and testing for FVIII/FIX inhibitors. This review focuses on activated partial thromboplastin time (APTT)-based one-stage assays (OSAs) and two-stage chromogenic substrate assays (CSAs). Currently, there is considerable inter-laboratory variability in the results obtained using OSAs, which can be intensified in a reagent-specific manner by the presence of the new modified recombinant factor replacement products that are entering the market. Furthermore, the use of CSAs, which tend to show less variability, especially with the new modified products, is recommended in a number of clinical scenarios. Clinical laboratories may, therefore, need to establish CSAs for routine use. In this review, we aim to improve understanding and help establish best practices by describing the methodology behind OSAs and CSAs and highlighting assay advantages and limitations. We argue that there can be value in offering both assay methodologies in clinical laboratories that contribute to the care of patients with haemophilia A or B. Educating both laboratory scientists and clinicians about the strengths and weaknesses of each type of assay will help to establish the necessary dialogue that is key to ensuring not only that the appropriate assays are used in the right clinical situations, but also that the results are interpreted correctly.</p>}},
  author       = {{Adcock, D. M. and Strandberg, K. and Shima, M. and Marlar, R. A.}},
  issn         = {{1751-5521}},
  keywords     = {{Chromogenic assay; Clinical laboratory; Factor activity assay; Haemophilia; One-stage assay}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{6}},
  pages        = {{621--629}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{International Journal of Laboratory Hematology}},
  title        = {{Advantages, disadvantages and optimization of one-stage and chromogenic factor activity assays in haemophilia A and B}},
  url          = {{http://dx.doi.org/10.1111/ijlh.12877}},
  doi          = {{10.1111/ijlh.12877}},
  volume       = {{40}},
  year         = {{2018}},
}