Bleeding Disorders

December 2023 Quick Question: VWF Subtype 2B

Our December 2023 Quick Question asks, “How do you test for VWD subtype 2B?” This is in follow-up to our February 2023 question, “What VWF activity assay do you use?” VWD subtype 2B is a qualitative VWF deficiency caused by a gain-of-function mutation that increases VWF-platelet-binding avidity. Please answer the quiz and post your comments […]

Bleeding Disorders

Recombinant ADAMTS13 Therapeutic

On November 9, 2023, Takeda’s recombinant ADAMTS13 received FDA approval for the care of congenital thrombotic thrombocytopenic purpura [cTTP]. Click here for their news release. Click here for the US Thrombotic Microangiopathy Alliance for more cTTP information and information on the family of TMAs.

Bleeding Disorders

ISTH Releases Management of Chemotherapy-induced Thrombocytopenia

The ISTH Subcommittee on Hemostasis & Malignancy just released the following guidelines. Soff G, Leader A, Al-Samkari H, et al.. Management of chemotherapy induced thrombocytopenia: Guidance from the ISTH Subcommittee on Hemostasis & Malignancy. J Thromb Haemost. 2023;10:S1538-7836(23)00734-1. doi: 10.1016/j.jtha.2023.09.031. Epub ahead of print. PMID: 37827380.

Platelet Function Testing

Northeast Laboratory Conference, October 17 and 18

the Northeast Laboratory Conference is this week, Tuesday, October 17, and Wednesday, October 18 at the Holiday Inn By the Bay, 88 Spring Street, Portland Main. I [Geo] lead an interactive session, “Trauma-Induced Coagulopathy and Massive Transfusion Protocol,” geared toward Hematology, Hemostasis, and Transfusion Medicine specialists from 10–11:30. Click here for the handout. My second […]

Bleeding Disorders

Von Willebrand Disease Subtype 2N

Von Willebrand disease subtype 2N is an autosomal recessive disorder in which the VWF D’D3-domain FVIII binding site is defective. Nearly 100% of FVIII circulates in a dynamic complex with normal VWF protected from activated protein C lysis. FVIIi, like carrier molecule VWF, has a 12-hour half-life. Uncomplexed FVIII in VWD subtype 2N has a […]

Bleeding Disorders

FVIII-depleted Plasma with VWF

Precision BioLogic’s successful Factor VIII Deficient Plasma with VWF is now FDA-cleared for sale in the U.S. [Precision BioLogic supports Fritsma Factor]

Bleeding Disorders

Erroneous Factor Assay Order?

Here is a 9-21-23 follow-up from Dr. Emmanuel Favaloro to our provocative September 8, 2023 discussion, Arabic Numerals. “OK, here’s one from today! Specimen management staff booked the sample for factors XIII, IX, XI, and XII! FVIII was not booked in.” Bob Gosselin responded, “Whatever is chosen, there will be those industrious few who will […]

Bleeding Disorders

Coagulation Testing in Hyperviscosity

Rae Kerlin from the Ohio State University Werner Medical Center wants to provide coagulation testing for a patient who has type I cryoglobulinemia [monoclonal IgM kappa]. Rae’s team team ordered a PFA but they were unable to obtain results due to hyperviscosity. PT/PTT = 13.9/24.7. They are planning to test FVIII via the 0ne-stage clotting […]

Bleeding Disorders

Follow-up to “FDA Approves Hemophilia A Gene Transfer Therapy”

This is a follow-up to “FDA Approves Hemophilia A Gene Transfer Therapy,’ posted July 3, 2023, with reference to Dr. Emmanuel Favaloro’s comment, added August 9 and citing Valentino LA, Kaczmarek R, Pierce GF, et al. Hemophilia gene therapy: first, do no harm. J Thromb Haemost. 2023: S1538-7836(23)00501-9. doi: 10.1016/j.jtha.2023.06.016. [click for a copy]. The […]

Bleeding Disorders

DIC and Hemolysis

Anne D’ Agostino asks, “Should we reject hemolyzed samples from someone in DIC?” The simple answer is “do not reject,” because the hemolysis is likely intravascular, reflecting DIC‘s microangiopathic hemolytic anemia [MAHA]. But to elaborate, there’s no foolproof way to differentiate intravascular [in vivo] hemolysis from spurious [in vitro] hemolysis, the consequence of specimen collection […]

Bleeding Disorders

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George Fritsma is a medical laboratory scientist, educator, and author. George holds faculty appointments with Rutgers University and Michigan State University, and is a member of the International Society on Thrombosis and Hemostasis, American Association of Clinical Chemists, and American Society for Clinical Laboratory Science.

Cheat Sheets from George

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