PROPHYLACTIC TRANSFUSION FOR HYPERTROPHIC SYNOVITIS IN CHILDREN WITH HEMOPHILIA

A 7- to 9-month protocol of prophylactic transfusion was used to treat 33 joints in 19 children with severe hemophilia (< 1 U/dL Factors VII I or IX) and hypertrophic synovitis, The overall rate of hemarthrosis was reduced, but only 36% (12 of 33 joints) achieved a good result (de fined as 0-0.5 bleeding episodes per month and decreased synovial hype rtrophy 1 year after completing treatment), Age and severity of arthro pathy at initiation of treatment did not affect the result, The degree of synovial hypertrophy and involvement of the knee joint showed an a dverse trend, but these factors did not achieve statistical significan ce, The number of episodes of breakthrough bleeding during the first 6 weeks of therapy was significantly associated with a poor result, Bas ed on the results of this study, a trial of transfusion therapy is rec ommended for recurrent hemarthroses and synovitis in patients with hem ophilia, but the duration of thrice weekly treatment has been increase d and the duration of prophylaxis has been reduced in selected cases.