Acquired factor VIII inhibitors?successful treatment with an oral outpatient regimen

Abstract

A rare cause of a spontaneous, life threatening coagulopathy in adults is the development of autoantibodies to factor VIII. We recently had the opportunity to treat seven patients with this disorder. After stabilization, they were given a regimen consisting of prednisone and oral cyclophosphamide. All patients had a complete response to treatment. The median time to response was three weeks. Durable remissions were achieved, making this oral regimen an acceptable treatment for this disorder. Am. J. Hematol. 60:70-71, 1999.

Acquired hemophilia A in the United Kingdom: a 2-year national surveillance study by the United Kingdom Haemophilia Centre Doctors' Organisation

“…[4][5][6][7][8][9][10][11][12][13][14][15][16] This is likely to have led to the reporting of more severely affected and younger patients. This view is supported by the finding that the patients reported in this series 1,20,21 are significantly older than previously reported, have a lower incidence of pregnancy-related acquired hemophilia, and a higher incidence of malignancy.…”

“…29,30 The studies reporting immunosuppressive regimens have almost invariably been singlecenter cohorts that have not included controls. [4][5][6][7][8][9][10][11][12][13][14][15][16] These studies will tend to preferentially report good outcomes as opposed to average or poor outcomes and journals will similarly be more likely to publish good outcome studies. One randomized study published to date found no difference between nonremitters randomized to cyclophosphamide and those that continued with steroids after an initial 3-week course of steroids.…”

“…The clinical characteristics of the disease have been previously described. [1][2][3] The literature describing acquired hemophilia A is based on tertiary referral single-center cohorts, [4][5][6][7][8][9][10][11][12][13][14][15][16] larger retrospective surveys of referral center patients, 1,5,[17][18][19] and patients reported because they have been treated for bleeding. [20][21][22][23] These reports have been combined in a review and meta-analysis.…”

“…22,23 Data on inhibitor eradication, however, are based on relatively small, uncontrolled single-center cohorts [4][5][6][7][8][9][10][11][12][13][14][15][16] and a metaanalysis. 24 These reports are potentially unrepresentative because referral center patients may be a subgroup of patients.…”

Rituximab for the treatment of acquired antibodies to factor VIII

“…The original data of individual patients were described in the articles by Herbst, 33 Lian, 34 Bayer, 35 Shaffer 36 and Huang.…”