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Hemophilia with Factor VIII Inhibitor: Elimination of Anamnestic Response

RICHARD S. STEIN, M.D.; and ROBERT W. COLMAN, M.D., F.A.C.P
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▸Address requests for reprints to Robert W. Colman, M.D., Hematology Research Laboratory, Massachusetts General Hospital, Fruit St., Boston, MA 02114.


Boston, Massachusetts


Ann Intern Med. 1973;79(1):84-87. doi:10.7326/0003-4819-79-1-84
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A 16-year-old hemophiliac with a circulating inhibitor to factor VIII was treated with cyclophosphamide, prednisone, and large doses of factor VIII concentrates. Therapeutic levels of factor VIII were obtained, the patient responded clinically, and the inhibitor disappeared completely by the 19th day. When bleeding episodes recurred on two separate occasions, infusions of factor VIII failed to provide a reappearance of the antibody despite the absence of further immunosuppressive treatment. Providing that the titer is such that antigen excess can be obtained, this therapeutic approach may be useful not only in eliminating factor VIII inhibitors but also in preventing the usually observed anamnestic response.

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