Late immune tolerance induction in haemophilia A patients

Summary The incidence of inhibitor development in patients with severe haemophilia A is approximately 30%. Immune tolerance induction (ITI) is commonly utilized to eradicate these antibodies and is successful in 63–100% of cases. Potential predictors of a poor outcome in ITI include a high preinduct...

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Bibliographic Details
Published in:Haemophilia : the official journal of the World Federation of Hemophilia 2013-05, Vol.19 (3), p.445-448
Main Authors: Meeks, S. L., Chapman, R. L., Kempton, C., Dunn, A. L.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Child
Child, Preschool
Cohort Studies
factor VIII
Factor VIII - antagonists & inhibitors
Factor VIII - immunology
Factor VIII - therapeutic use
haemophilia A
Hemophilia A - drug therapy
Hemophilia A - immunology
Humans
Immune Tolerance
inhibitor
Isoantibodies - blood
Male
Young Adult
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Summary:Summary The incidence of inhibitor development in patients with severe haemophilia A is approximately 30%. Immune tolerance induction (ITI) is commonly utilized to eradicate these antibodies and is successful in 63–100% of cases. Potential predictors of a poor outcome in ITI include a high preinduction titre, high historical peak titre, older age at start of ITI and prolonged interval from diagnosis to start of ITI. The goal of this study was to characterize the outcomes of patients from our centre who have undergone late ITI, many of whom had poor prognostic features. Medical records of patients in our centre with severe/moderately severe haemophilia A (6 h). Three patients are partially tolerized (have low responding inhibitor, variable FVIII recovery and successfully treated with FVIII products). Two patients are not tolerized. Some patients with haemophilia A and long‐standing inhibitors may benefit from ITI.
ISSN:1351-8216
1365-2516
DOI:10.1111/hae.12077