12th Congress of the European Hematology ... - Haematologica

12 th Congress of the European Hematology Association
nario, many drugs in varied combinations have been employed to
achieve the completion of the pregnancy. Nevertheless, the results are
often unsuccessful. 46 consecutive healthy women, age ranging 18-52
years (median 39.2 yrs), with body mass index in normal average, with
ARI from 2 to 9 in each subject and/or RFL at 2nd trimester of pregnancy
were treated early at he onset of their umpteenth gestation. 11 of
them have had one birth in the list of their ARI and/or RFL. 8/47 had
venous thromboembolism in juvenile age. In 40 pregnant females we
documented a hypercoagulation proneness and/or several genetic
thrombophilia mutations: ATIII deficit (n=1), PC reduction (n=3), PS
deficiency (n=6), LAC (n=7), ACA (n=11), APA (n=8), A beta2 -GP-I
(n=9), increased PAI-1 activity (n=13), elevated D-dimer (n=33), Prothrombin
mutation (n=15 etherozygousity and n=2 homozygous state),
FV Leiden (n=10 etherozygousity and n=1 homozygous condition),
combined FII and FV Leiden (n=5), MTHFR (n=30 etherozygous pattern
and n=10 homozygous state). Hyperomocysteinemia (> 14 µg/mL)
was found in 9 subjects. The following therapeutical strategy was performed:
oral prednisone (10 mg/die) until the 2nd trimester of the pregnancy
and 5 mg/die till the eight month, aspirin (50-100 mg/die), and
subcutaneous low molecular weight heparin (LWMH at mean dosage
4.000 IU/die) till the eight month, intramuscular progesterone until the
fourth month. Folic acid and vitamin B complex were orally administered
until the completion of the pregnancy. If necessary, oral iron preparations
were also given. Body mass index and diet style were monitored.
41 females successfully completed their pregnancy; 2 of them had
eclampsy at the sixth month with miscarriage. From our observations
we suggest that the reported therapeutical combination may prevent
ARI or RFL and IFGR even in women with personal documented plasma
hypercoagulation and genetic thrombophilic risk factors.
0825
PROTHROMBIN ACTIVITY AND ANTIGEN IN CARRIERS OF PROTHROMBIN G20210A
MUTATION
F. Torelli, A. Chistolini, M.G. Mazzucconi, P. Pignoloni, C. Santoro,
C. Mercanti, F. Cerutti, R. Foa
Ematologia, ROMA, Italy
Background. Prothrombin (FII) G20210A mutation and elevated plasma
prothrombin activity are known risk factors for thromboembolic
diseases. Aims. The aims of our study are 1) the evaluation of prothrombin
activity (FII:C), antigen (FII:Ag) in patients affected by heterozygous
prothrombin G20210A mutation compared to a normal population, 2)
the evaluation of prothrombin antigen and activity in heterozygous prothrombin
G20210A muatation in patients with and without thromboembolic
events. Methods. We studied 63 subjects (14 men and 49
women, median age = 42 years, range =24-72 years) with the prothrombin
G20210A polymorfism (Group A) and a control population (14 men
and 49 women, median age = 40 years, range = 20-76 years) (Group B).
In the Group A 34/63 (54%) patients presented previous thromboembolic
events. Normal ranges of FII:C and FII:Ag were 80-126 U.I./dL
(Mean=103, SD=11.5) and 50-150 U.I./dL (Mean = 100, SD= 25) respectively.
Results. In the Group A, mean value of FII:C was 122.6 U.I./dL
(SD=18.9) and 105.7 U.I./dL (SD= 12) in the Group B (p