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Blood, 1 August 2007, Vol. 110, No. 3, pp. 815-825.
Prepublished online as a Blood First Edition Paper on April 19, 2007; DOI 10.1182/blood-2006-10-050435.


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CLINICAL TRIALS AND OBSERVATIONS

Mortality rates, life expectancy, and causes of death in people with hemophilia A or B in the United Kingdom who were not infected with HIV

Sarah C. Darby1, Sau Wan Kan2, Rosemary J. Spooner3, Paul L. F. Giangrande3,3, Frank G. H. Hill4, Charles R. M. Hay5, Christine A. Lee6, Christopher A. Ludlam7, Michael Williams, for the UK Haemophilia Centre Doctors' Organisation4

1 Clinical Trial Service Unit and 2 Cancer Epidemiology Unit, University of Oxford, Oxford; 3 Haemophilia Centre, Churchill Hospital, Oxford; 4 Department of Haematology, Birmingham Children's Hospital National Health Service Trust, Birmingham; 5 Department of Haematology, Manchester Royal Infirmary, Manchester; 6 Haemophilia Centre, Royal Free Hospital, London; 7 Haemophilia Centre, Edinburgh Royal Infirmary, Edinburgh, United Kingdom

Since the 1970s, mortality in the hemophilia population has been dominated by human immunodeficiency virus (HIV) and few reports have described mortality in uninfected individuals. This study presents mortality in 6018 people with hemophilia A or B in the United Kingdom during 1977 to 1998 who were not infected with HIV, with follow-up until January 1, 2000. Given disease severity and factor inhibitor status, all-cause mortality did not differ significantly between hemophilia A and hemophilia B. In severe hemophilia, all-cause mortality did not change significantly during 1977 to 1999. During this period, it exceeded mortality in the general population by a factor of 2.69 (95% confidence interval [CI]: 2.37-3.05), and median life expectancy in severe hemophilia was 63 years. In moderate/mild hemophilia, all-cause mortality did not change significantly during 1985 to 1999, and median life expectancy was 75 years. Compared with mortality in the general population, mortality from bleeding and its consequences, and from liver diseases and Hodgkin disease, was increased, but for ischemic heart disease it was lower, at only 62% (95% CI: 51%-76%) of general population rates, and for 14 other specific causes it did not differ significantly from general population rates. There was no evidence of any death from variant Creutzfeldt-Jakob disease or from conditions that could be confused with it.


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An actuarial GPS for hemophilic longevity
W. Keith Hoots
Blood 2007 110: 791-792. [Full Text] [PDF]



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