How Much Longer?

[stacey]

I'm sorry that this will sound so morbid, but since it's the tragic anniversary of the murder of the last Romanovs and their servants, I had to ask:

We all know that poor Alexei suffered terribly from hemophilia. Several of his hemophiliac relatives had already died of this disease, most at a very young age. Obviously at the turn of the 20th century there was no treatment available for people with his condition, and very few even survived to adulthood.

Alexei had already astonished his doctors by surviving a number of nearly fatal hemorrhages. At the time of his murder, he was still unable to walk. I think he was just short of his 14th birthday when he was killed? I even vaguely recall something that Rasputin allegedly once told the Empress: that if Alexei survived until his 15th birthday, he would be cured of his hemophilia and go on to live a normal life. IF there is any truth to that (and that's a huge "if", I grant you), if he could have lived just another year and a few weeks, who knows? Maybe--just maybe--Alexei could have overcome that terrible disease and lived a long and healthy life. IF he hadn't been murdered first!!!

Anyway, now to my question: even if the Revolution had never happened, even if the Romanov dynasty had continued to flourish--what do you think Alexei's ultimate fate would have been? How much longer would he have beaten the odds? How much longer would he have lived even in a peaceful Russia?

Again--sorry to be so morbid but I've started thinking about this and wondered what others might think. Of course as things turned out, poor Alexei never got the chance to find out. May he and his family rest in peace.

[Ortino]

There is still no cure for hemophilia, only treatments, so Rasputin was clearly wrong. Prince Leopold, Duke of Albany, effectively died of the disease at age 30. Prince Alfonso of Asturias also died around that age from his hemophilia. I think that Alexei could have made it to his 30s and beyond, but he would have had to have been extraordinarily careful.

[TimM]

If he made it to the 1930's, his chances would have improved.  That was the time they were able to start treating hemophilia patients with drugs.

[Sanochka]

I think it's only natural that someone interested in the Romanov family would wonder about these things.  I don't think it's morbid at all. 

At the time, so much rested on Alexei's' survival.  His country, its governance, his future as tsar, his immediate family's concern for his health, and his mother having spent so much of herself keeping him alive - all of this must have weighed heavily on his mind and couldn't have but increased his determination to survive. 

I read somewhere years ago - I think it was in a book by Robert Massie - that Alexei would most likely have lived to his 30s and, as Tim says, newly developed treatment with drugs.  It's a tantalizing thought.  But sadly, we'll never know.

[Kalafrana]

As far as I'm aware, there was no drug treatment in the 1930s. However, blood transfusion became generally available, as techniques for storing blood were developed.

Around 1990 I worked on the HIV haemophilia litigation (my boss acted for the Newcastle Haemophilia Centre, which was one of the defendants). Part of my involvement was going through the medical records of the haemophiliacs treated in Newcastle, and it was noticeable thaat all of them who were more than 30-ish had had long periods in hospital as boys as a result of bleeds, and wrecked joints. By contrast, the ones in their early 20s and younger had been on Factor VIII virtually all their lives and were much less badly affected by the haemophilia. They had to avoid contact sports, but their education had not been messed up, they had proper jobs (one was a physiotherapist, another a geologist).

So I think Alexei would have had to have lived until the 1960s or later, and by then the damage would have been done. Bear in mind that Alfonso, his brother and Rupert of Teck all died as a result of car accidents. Alexei would, I think, have become a fast driver in adult life.

Ann

[Romanov_Fan19]

he  could have im sure  lived  at least too  45  (although I Have no knowledge of his condition)

[Kalafrana]

Waldemar of Prussia lived to 56, but he was most unusual. All the other royal haemophiliacs who reached adulthood died young. It sounds as though Waldemar was a much quieter person than Alexei, and so less liable to the kind of minor injuries that provoked bleeds, but even Leopold, also fairly quiet, only reached 30, and died after a fall.

I really don't see Alexei as living much beyond 20, and certainly not healthily.

Ann

[TheLionandTheEagle]

He was doing poorly at the time of the murder, but that was because of a fall down stairs in a sled in captivity -- so not likely to happen in a peaceful Russia.  Perhaps he might have made it into his 20s or 30s, but I doubt he would have lasted long enough to benefit from Factor VIII, sadly.  And if he did, he would have been VERY disabled.  Ironically, any son he would sire would NOT have hemophilia, because it is X-linked.  So perhaps, if he married quickly, he would have been able to father children and continue the dynasty that way.

[JamesAPrattIII]

I don't think Alexei as tsar would have been allowed to drive cars.

Alexei did not hurt himself in a sled fall. His last attack was do to the fact he got whooping cough from Dr Derevenko's son and burst a blood vessel while coughing. It's in Buxhoeveden's bio of Alexandra which is on this site and Alexandra'ss last diary.

[Romanov_Fan19]

I Never  Heard the story of the  Cough

[Sarushka]

Nicholas and Alexandra's diaries also attribute Aleksei's last bout with hemophilia to a cough. (Though I don't think it was whooping cough specifically.) Neither of them mention the sledding incident as a probable cause. If you hunt around here you'll find a lengthier discussion with dates and excerpts from various sources.

[Kalafrana]

If all it took to cause a major haemorrhage was a bad cough, then I fear Alexei might well not have lasted much longer.

Ann

[gillian]

There wasn't really any treatment for hemophilia until the middle of the 20th century and then just when things were looking up HIV/AIDS happened. Most of Alexei's hemophiliac cousins, except Waldemar of Prussia, all died in accidents in their early twenties. So even if the Romanov family had survived or the Russian Empire not crumbled things still seem pretty bleak. I agree that Nicholas and Alexandra probably wouldn't let him drive a car. The other leading cause of death for hemophilia victims is falls and that's going to happen no matter how protected a person is. So he probably had a few more years but I doubt he would have outlived his father and even became tsar. Still you never know, his cousin Waldemar did live to be 56 despite his hemophilia so it's impossible to say anything with certainty.

[Kalafrana]

Romanov men weren't long lived. Only a few got past 70, so I see Nicholas as being dead by 1940. There were 36 years between Nicholas and Alexei, so Alexei would have had to live into his 30s to survive him, which doesn't sound all that likely.

Ann

[Romanov_Fan19]

Wonder  why  The men   all died   pretty  young