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What are the potential complications of treatment with factor replacement therapy in patients with haemophilia?
Answer
Potential complications associated with factor replacement therapy in patients with haemophilia primarily include the development of inhibitors and acute transfusion reactions. The most serious complication is the development of inhibitors, which are antibodies that render the replacement factor ineffective, making treatment challenging ((Peyvandi et al., 2016)). As with any blood product transfusion, patients receiving factor replacement should be monitored for acute transfusion reactions, and staff should be able to monitor and manage these reactions 2. Historically, viral infections such as HIV and hepatitis C were significant risks associated with plasma-derived factor concentrates; however, modern purification techniques and the use of recombinant factors have largely eliminated these risks ((Peyvandi et al., 2016)). Additionally, individuals with bleeding disorders, including those on factor replacement, should be aware of the risk of haematoma from intramuscular injections, such as vaccinations, and appropriate techniques like using a fine needle and applying firm pressure should be employed to minimise this risk 5.
Key References
- CKS - Deep vein thrombosis
- NG24 - Blood transfusion
- CKS - Anticoagulation - oral
- NG39 - Major trauma: assessment and initial management
- CKS - Immunizations - seasonal influenza
- NG121 - Intrapartum care for women with existing medical conditions or obstetric complications and their babies
- (Peyvandi et al., 2016): The past and future of haemophilia: diagnosis, treatments, and its complications.
- (Nogami and Shima, 2023): Current and future therapies for haemophilia-Beyond factor replacement therapies.
- (Chowdary et al., 2025): Haemophilia.
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