Induction of immune tolerance in patients with hemophilia A and inhibitors treated with porcine VIIIC by home therapy

Autor:	C. R. M. Hay, P. B. A. Kernoff, Y. Laurian, F. E. Preston, F. Verroust
Rok vydání:	1990
Předmět:	medicine.medical_specialty business.industry Home therapy Immunology Follow up studies Cell Biology Hematology Factor VIIIc inhibitor medicine.disease Hiv seropositivity Biochemistry Immune tolerance Internal medicine Coagulopathy Medicine In patient business Factor VIIIc
Zdroj:	Blood. 76:882-886
ISSN:	1528-0020 0006-4971
DOI:	10.1182/blood.v76.5.882.882
Popis:	Home therapy with porcine factor VIIIC was safe and effective when administered to five hemophilic patients over periods of 8 1/2, 6, 4, 3 1/2, and 2 years. No significant transfusion reactions occurred. Before treatment with porcine factor VIIIC, all five had high-level, high- responding anti-human VIIIC inhibitors initially lacking anti-porcine factor VIIIC activity. Although specific anti-porcine VIIIC inhibitors arose in all patients, these were generally transient, and only one patient became refractory to treatment. We believe that porcine factor VIIIC is the treatment of choice in patients whose inhibitors do not cross-react. All five patients lost their original anti-human VIIIC inhibitors after starting treatment with porcine VIIIC, permitting the reintroduction of human VIIIC in three of them. There has been no recurrence of anti-human VIIIC inhibitor activity during 2 to 3 years of regular treatment with human VIIIC in these patients. This suggests that tolerance to human VIIIC has arisen as a result of treatment with porcine VIIIC. Porcine VIIIC may have a role in the desensitization of some factor VIIIC inhibitor patients.
Databáze:	OpenAIRE
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