Therapy of Coagulation Factor VIII Autoantibodies with Long-term Extracorporeal Protein A Adsorption and Immunosuppression

Autor: Ralf Grossmann, Dieter Wiebecke, Franz Keller, Behrouz Mansouri Taleghani
Rok vydání: 1997
Předmět:
Zdroj: Transfusion Science. 19:39-42
ISSN: 0955-3886
DOI: 10.1016/s0955-3886(97)00101-x
Popis: Acquired factor VIII (FVIII) inhibitors in non-haemophiliacs may pose serious treatment problems.For IgG-adsorptions we utilized an automated plasma separation device and a plasma flow monitor.A 63-year old woman showed life-threatening bleeding because of an inhibitor. After stabilization by porcine FVIII three cycles of a modified Malmoe treatment protocol were applied, followed by long-term cyclophosphamide p.o. and weekly IgG-adsorptions. Within twelve months the patient exhibited a complete remission. A 54-year old man presented a comparable history. Because of a good response after the first cycle he was subsequently switched to the long-term therapy. Up to now (7 months) FVIII activities and inhibitor titers remained stable (10-20% rsp.3 BU/ml). In both cases no FVIII substitution therapy was necessary.A modified Malmoe protocol combined with long-term cyclophosphamide p.o. and weekly IgG-adsorptions seems to be an efficient, safe and cost-effective regimen for non-haemophiliacs with FVIII inhibitors.
Databáze: OpenAIRE