Rituximab in the treatment of acquired factor VIII inhibitors. Academic Article uri icon

Overview

abstract

  • Autoantibodies against factor VIII (FVIII) are rare but can cause life-threatening bleeding requiring costly factor replacement and prolonged immunosuppression. We report 4 consecutively treated patients whose acquired FVIII inhibitors responded rapidly to immunosuppressive regimens that included rituximab, a monoclonal antibody against CD20(+) B cells. Three patients had spontaneously occurring inhibitors. The fourth, a patient with mild hemophilia A, developed both an autoantibody and an alloantibody following recombinant FVIII treatment. Pretreatment FVIII activities ranged from less than 1% to 4% and inhibitor titers from 5 to 60 Bethesda units (BU). One patient with polymyalgia rheumatica who developed the inhibitor while receiving prednisone responded to single agent rituximab. The hemophilia patient had rapid resolution of the autoantibody, whereas the alloantibody persisted for months. Responses continue off treatment from more than 7 to more than 12 months. This report adds to the growing evidence that rituximab has efficacy in immune disorders resulting from autoantibody formation.

publication date

  • November 1, 2002

Research

keywords

  • Antibodies, Monoclonal
  • Autoantibodies
  • Autoimmune Diseases
  • Factor VIII
  • Hemophilia A
  • Immunosuppressive Agents
  • Isoantibodies

Identity

Scopus Document Identifier

  • 0036839526

Digital Object Identifier (DOI)

  • 10.1182/blood-2002-03-0765

PubMed ID

  • 12384448

Additional Document Info

volume

  • 100

issue

  • 9