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September 7, 1970

Hemophilia and Aspirin

JAMA. 1970;213(10):1689. doi:10.1001/jama.1970.03170360087028

To the Editor.—  Real progress in improving the lot of the hemophiliac depends on a broad understanding of his disease and on the utilization of those clinical observations that have contributed to the establishment of sound therapy. Unfortunately, the editorial on "Hemophilia Prophylaxis" (212:2256-2257, 1970) failed in both aspects.One can challenge the correctness of the statement: "The feasibility of prophylaxis depends on the plasma clotting-factor level needed for reasonable protection, and on the frequency of infusions necessary to maintain the level." If this were true, how can the course be explained of the two hemophilic brothers who both had a concentration of factor VIII so low that it can only be estimated to be about 0.01% of normal?1 One has no crippling hemarthrosis and has required transfusions on only two occasions in his 19 years of life, whereas his 20-year-old brother is now so crippled with joint