Abstract
Immunosuppressive therapy for Factor VIII inhibitors has been studied by different investigators with variable results. Over a 6 year period, 68 patients with Factor VIII inhibitors were randomized into 3 separate protocols: The high responder group showed 3 separate patterns: 1) reduction of inhibitor & prevention of anamnestic response as long as cyclo-phosphamide therapy was maintained; 2) disappearance of inhibitor & no recurrence when exposed to Factor VIII after cyclophos-phamide therapy termination; 3) persistence of inhibitor but in low responder range without anamnestic response to Factor VIII infusions after cyclophosphamide therapy termination. Controls developed an anamnestic inhibitor response each time they were exposed to Factor VIII. The low responder group showed 2 patterns: 1) disappearance of inhibitor without recurrence when exposed to Factor VIII; 2) persistence of inhibitor in low responder range. The low responders reacted the same during immunosuppression & after termination of the immunosuppression therapy. Controls showed the same results as the protocol group. It is evident from these results that immunosuppression was apparently unnecessary for the low responders but gave beneficial results with the high responders.
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