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Norris Cotton Cancer Center
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Norris Cotton Cancer Center's hemophilia program is one of three Federally Designated Comprehensive Hemophilia Treatment Centers (HTC's) in northern New England. This is especially relevant because a CDC study of 3,000 people with hemophilia showed that those who used a hemophilia treatment center were 40% less likely to die of a hemophilia-related complication compared to those who did not receive care at a treatment center. Similarly, people who used a treatment center were 40% less likely to be hospitalized for bleeding complications.

The Cancer Center and Dartmouth-Hitchcock have the only onsite diagnostic coagulation lab within a 100-mile radius of Lebanon, and the only diagnostic coagulation clinic in NH. We conduct hundreds of pediatric and adult new patient workups for congenital thrombosis and bleeding disorders each year, and clinic evaluations are held twice weekly.

Our Blood Bank is the only facility within a 100-mile radius to maintain a full complement of hemophilia products to manage any hemophilia problem or emergency.

Services provided include:

  • Comprehensive, multidisciplinary hemophilia care
  • Diagnostic evaluation and treatment of abnormal bleeding
  • Hemostasis planning for invasive procedures, pregnancy and childbirth
  • Personalized thrombophilia screening and thrombosis risk assessment
  • Recommendations for thromboprophylaxis and anticoagulant bridging therapy
  • Family studies and genetic counseling for inherited disorders of thrombosis and hemostasis

All patients with moderate or severe hemophilia are candidates for home IV factor infusion. Currently 90% of patients meeting the criterion over 5 years of age self-infuse or are infused by a family member.

Other services, in detail:

  • Factor replacement products
  • On-site diagnostic coagulation laboratory providing rapid turnaround for factor assays and other specialized studies, including platelet aggregations
  • Patient Registry that facilitates rapid and appropriate emergency treatment
  • Qualitative and quantitative assays for diagnosing bleeding and thrombosing disorders
  • Risk assessment and risk management in patients with idiopathic and cancer-associated thrombosis
  • Management of therapy-resistant thrombosis
  • Genetic counseling for bleeding and thrombosing disorders, and testing of susceptible individuals
  • Anticoagulant clinic patient management
  • Screening for viral exposure associated with clotting factor and for joint morbidity associated with congenital bleeding disorders
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