Session: 322. Hemophilia A and B: Clinical and Epidemiological: Poster I
Hematology Disease Topics & Pathways:
Bleeding and Clotting, Hemophilia, Diseases
To evaluate the safety and efficacy of Radiosynoviorthesis in Chronic Synovitis in Persons with Hemophilia.
Materials and Methods :
This retrospective observational study reviewed all radiosynoviorthesis conducted in persons with Hemophilia (PWH) from June 2016 to May 2024. Yttrium-90 (68%) was used for knee and shoulder joints. Lutetium-177(32%) was used for elbow, wrist and ankle joints.
The inclusion criteria were patients of any sex, ³8 years or older, with stage 2 and 3 haemophilic arthropathy and target joint. Exclusion criteria included patients <8 years, pregnant females, those with acute bleeds, local infections, and stage 4 haemophilic arthropathy. Data were collected on resolution of target joints, functional (FISH and HJHS)and radiological score (Denver) before the procedure and at 1, 3, 6 months and 12 months post-procedure to assess the efficacy of the intervention.
Results
A total of 115 procedures were performed in 81 PWH. The median age of patients was 22 years (range: 8-62). Of all the cases, Haemophilia A were 85.3% (n=98), Haemophilia B were 10.4% (n=12), Hemophilia A with Inhibitor were 4.3% (n=5). Among all 94.4% were severe haemophiliacs and 5.6% were moderate haemophiliacs. Of 115 procedure, 57% (n=41) were knee, 25%(n=22) were elbow 13.8% (n=16) were Ankle, 3.4%(n=2) were shoulder joints. The majority 69% of patients had a good Caviglia score, while 31% had a poor score. Out of 81 PWH, 37 PWH with 56 (48.6%) procedures followed up regularly at the defined time-points and assessment was done accordingly. Out of 56 joints 50 had resolution of target joints. Median FISH, HJHS and VAS Scoring at pre procedure, 1 month, 3 months and 6 months are (27, 25, 25 and 24), (18,16,15 and 15) and (6, 5, 5 and 5) respectively with statistically significant improvement (P <0.001). The Denver score didn’t show any statistical difference post procedure. The procedure was safe, with two episodes of skin burns reported.
Conclusion : People who followed regularly has a decrease in the Annual Joint Bleed Rate. Radiosynovectomy is safe and effective intervention for patients with chronic haemophilic arthropathy irrespective of the type of radionuclide used
Disclosures: No relevant conflicts of interest to declare.
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