Although it is only in the last 50 years or so that hemophilia and its treatment has been really understood, the disorder has a much longer history. Here are some of the major milestones in the history of hemophilia and its treatment. While this timeline focuses mostly on the breakthroughs and successes, it should be noted that the evolution of medical care of hemophilia was not a straightforward progression. There were many bumps and turns along the way to understanding this disorder and developing effective treatment.
circa 100
First written reference to a bleeding disorder, by Rabbi Judah the Patriarch, exempting male infants from circumcision if elder brothers had died as a result of this procedure.
circa 1100
Albucasis, an Arabic physician, documents in a medical handbook that uncontrollable bleeding disease in males is best treated with cautery. This is the first written reference to hemophilia treatment.
Moses Maimonides, a physician and talmudist who lived in Egypt, extends Rabbi Judah’s ruling exempting male infants from circumcision to the sons of women who have married twice, suggesting an awareness of the inheritance of hemophilia.
1793
Consbruch of Germany publishes the first modern description of hemophilia.
1803
American physician John Conrad Otto publishes an article on hemophilia that stimulates research and publication by others.
1823
The term hemophilia is coined by Schonlein of Germany for all bleeding problems; the term is applied to just inherited disorders after 1828, when it is first published in the title of a dissertation by a student of Schonlein’s.
1840
The first successful blood transfusion for postoperative bleeding in a boy with hemophilia is performed by Samuel Lane, an English physician.
1853
Queen Victoria of England’s son, Leopold, is born with hemophilia. Two of Queen Victoria’s daughters are carriers and spread what becomes known as “the royal disease” throughout the ruling families of Europe and Russia.
1904
Alexis, son of Tsar Nicholas II of Russia, is born with severe hemophilia.
1934
R.G. MacFarlane, a British pathologist, learns that Russell’s viper venom helps hemophilic blood to clot. Commercial production of “Stypen” for hemophilia treatment begins soon afterwards; it is still produced today.
1936
Plasma first used to treat hemophilia.
1937
American researchers A.J. Patek and F.H.L. Taylor find that intravenous administration of plasma precipitates shortens blood clotting time. Taylor later calls the precipitates antihemophilic globulin.
1939
American pathologist Kenneth Brinkhous shows that people with hemophilia have a deficiency in the plasma factor he later calls antihemophilic factor, now called factor VIII.
1944
Edwin Cohn, an American biochemist, develops fractionation, a process of separating plasma into its different component parts.
1946
Cohn and his colleagues demonstrate that one of the blood fractions (Cohn Fraction I) indicated antihemophilic activity. American physician Armand Quick came to the same conclusion using different methods in the same year.
1952
Researchers in San Francisco, New York, and Oxford describe a new type of hemophilia, arising from a defect in what is now known as factor IX. Rosemary Biggs from Oxford U.K. calls it Christmas disease, named for the first patient, Stephen Christmas.
1955
American pathologists Robert Langdell, Robert Wagner, and Kenneth Brinkhous develop intravenous infusions of factor VIII, the first effective therapy for hemophilia.
1957-8
Human preparations of factor VIII are developed in Britain, France, and Sweden.
1958
Inga Marie Nilsson, a Swedish physician, begins prophylaxis in treatment of boys with severe hemophilia A. Regular prophylactic treatment does not begin until the early 1970s.
1961
First experiments with concentrates of factor VIII.
1964
American researcher Judith Pool publishes a paper reporting that freezing and thawing plasma slowly produces a by-product which is rich in factor VIII. Cryoprecipitate revolutionizes the treatment of hemophilia.
Mid-1960s
Total hip replacement and later knee replacement surgery is developed in the U.K.
1968
First factor VIII concentrate becomes commercially available.
1977
Italian Pier Mannucci recognizes that desmopressin (DDAVP) can boost the level of both factor VIII and von Willebrand factor in blood.
1980
Bovine spongiform encephalopathy (BSE) epidemic begins in cattle herds in the U.K.
1982
First reported cases of AIDS in people with hemophilia.
1984
First experiments with heat-treated product conducted by the U.S. Centers for Disease Control and Prevention, which showed that heat destroyed HIV.
Factor VIII gene is characterized and cloned.
1985
Viral-inactivated factor concentrates become available.
ELISA and Western Blot Test are developed to test antibodies for HIV.
1989
Hepatitis C virus, previously called non-A, non-B, is identified.
1991
Testing for hepatitis C is introduced.
1992
First recombinant factor VIII products become available.
1995
First case of variant Creutzfeldt-Jakob disease, the human form of Mad Cow disease, is identified in the U.K.
1997
First recombinant factor IX products become available.
1998
Gene therapy trials on humans begin.
Last updated March 2003 |
