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In 1985 Dr Mayne listed the following volumes of product usage: In 1982: lmmuno 648,707; Armour 478,137; NHS 12,960. In 1983: Immuno 451,497; Armour 505,844; NHS 159,090. In 1984: Immuno 441,408; Armour 506,184; NHS 525,710.529.

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Dr Mayne suggested that "It is clear from these figures that the increased use of N.H.S. material should have produced an economy in the purchase of commercial material but, due to extensive orthopaedic surgery being necessary following a series of road traffic accidents and bone fractures, the increase in N.H.S. material was inadequate for needs."

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It was reported that all three of the patients identified in the July MMWR had died and more cases had been identified, including two patients aged ten or under, leading to the
observation that "children with hemophilia must now be considered at risk for the disease."

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A patient with severe haemophilia raised concerns regarding the possibility of acquiring AIDS.

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Professor Bloom stated "there is certainly no need for the haemophilic community to be unduly concerned about this 'new' syndrome. They can rest assured that every effort
is being made to monitor the situation in this country and to collaborate with the Centre for Disease Control in the U.S.A."

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Dr Evatt wrote to Professor Bloom "The evolution of the epidemic is occurring with a frightening pace...The incidence rate has been increasing in hemophiliacs and the epidemic curve paralays that of the total epidemic curve."

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It was suggested people with mild haemophilia and von Willebrand disorder DDAVP should be used for minor lesions, or cryoprecipitate or NHS concentrate for other lesions; for children with severe haemophilia cryoprecipitate or NHS concentrate should be used; for adults with severe haemophilia cryoprecipitate should be used.

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DDAVP featured on the Cardiff Haemophilia centre returns for the first time, and there was no record of its use to any significant extent in 1983. There was a reduction in the use of cryoprecipitate for the treatment of patients with Haemophilia A, with the main treatment product being NHS concentrates (809,972 units) and commercial concentrates (1,051,422 units).

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Professor Bloom wrote to Dr Boulton explaining for severely affected patients, they weren't differentiating between NHS concentrates and cryoprecipitate to treat them.

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Cardiff's Annual Return for 1984 recorded an increase in the use of cryoprecipitate, a greater increase in the amount of NHS concentrates used (1,704,313 units), and a reduction in the amount of commercial concentrates (861,677 units). The individual patient data filed with the 1984 return showed the treatment of a child born in 1971 with cryoprecipitate. The individual patient data filed with the 1984 return showed the treatment of a child born in 1983 with cryoprecipitate.

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Dr Rizza was in support of plans to set up an AIDS screening programme. The terms in which he wrote are instructive: "it is important that we act quickly to set up screening tests to detect the patients who might be at risk of developing the full blown condition."

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There was almost no cryoprecipitate used for the treatment of Haemophilia A. 1,636,580 units of NHS Factor 8 were used; over 4.5 million units of commercial concentrates were used.

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In 1984 there were almost no cryoprecipitate; 1,919,162 units of NHS Factor 8; and 3,907,595 units of commercial concentrates.

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The individual patient data shows people being treated with NHS and commercial concentrate and with more than one type of commercial concentrate.

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In December 1984, Oxford Haemophilia Centre placed its first order for heat-treated concentrates

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In Bradford, in 1982, there was a move away from the use of cryoprecipitate to factor concentrates and the introduction of home treatment

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In Bradford, in 1983, no cryoprecipitate was used for the treatment of patients with Haemophilia A; all treatment was with concentrates (NHS, Factorate and Kryobulin)

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In a Blood Transfusion Services meeting on 4th December 1984 it was said, theoretically, "heat-treated material was likely to be safer than non-treated material"

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Local directors in Bradford, having discussed the Elstree protocols, did not want interim heat-treated product that would only likely be available two or three months and preferred to wait until April when "a better product is promised"

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In 1976, St George's Hospital had begun to shift away from cryoprecipitate and towards concentrate, predominantly commercial. Predominantly still cryoprecipitate used.

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