In a November 2006 article published in Haemophilia, the journal of the World Federation of Hemophilia, a team of scientists confirms that a new lab test is useful in monitoring the health of people with hemophilia A. The test is called the Clot Formation and Lysis (CloFAL) global assay. This was the first research study to determine the test’s sensitivity to measuring the ability of blood to clot (coagulability) and dissolve clots (fibrinolytic potential) in people with hemophilia A. The study was led by Dr. Neil Goldenberg, a current NHF Clinical Fellow, associate director of the Mountain States Regional Hemophilia and Thrombosis Center and assistant professor of internal medicine and pediatrics at the University of Colorado Health Sciences Center in Denver.
Goldenberg and colleagues studied the sensitivity of the CloFAL global assay by comparing the coagulability and fibrinolytic potential of the blood of people with hemophilia A with the same measures in people who did not have hemophilia. They also observed the difference between the CloFAL assay readings in adults and children.
The investigation revealed that the clotting index (CI)–the measure of coagulability–of subjects with hemophilia was significantly lower than that of people who did not have hemophilia. In addition, the CloFAL assay showed differences in the coagulability of factor VIII (FVIII)-deficient blood according to the type of factor replacement used. Hemophilic blood treated with recombinant factor product yielded a lower CI than when it was treated with plasma-derived factor. This result is significant for its implications on the clinical treatment of hemophilia.
The CloFAL assay study results indicated that people with hemophilia A had a higher fibrinolytic potential–a measure of how readily the blood dissolves a blood clot–than healthy individuals. This distinction was consistent between adults and children. In general, children with hemophilia showed greater fibrinolytic potential than adults.
Currently, the CloFAL assay is not a standard laboratory procedure performed on people with hemophilia. However, the results of this study suggest that if the CloFAL assay were eventually used as a standard diagnostic test, then doctors would have another tool to monitor the clotting levels and overall health of people with hemophilia. Goldenberg and colleagues plan to conduct further research to verify the usefulness of the CloFAL assay to treat people with hemophilia A.
Source: Goldenberg, N. A., W. E. Hathaway, L. Jacobson, et al. “Influence of Factor VIII on Overall Coagulability and Fibrinolytic Potential of Haemophilic Plasma as Measured by Global Assay: Monitoring in Hemophilia A.” Haemophilia. 2006; 12: 605-614.