This is an interesting report on a small series of children with inherited platelet dysfunction treated with rFVIIa for acute bleeding or preoperatively. Response seemed to correlate with type of underlying condition, severity of bleeding and delay in presentation. In this series rFVIIa had variable efficacy in securing hemostasis. There was no difference in requirement for platelet transfusion in acute bleeding, but in 5 children treated with rFVIIa prior to planned surgery control was excellent and transfusion was not required. The authors comment that these results were not as good as other published reports, probably because all patients were children and presence of a large number of epistaxis which showed less favorable response to rFVIIa. Large studies are required to explore the role of rFVIIa in these disorders.
– Maadh Aldouri