Regimens of factor VIII administration--continuous infusion vs. bolus.
The Malmö protocol for immune tolerance induction uses intermittent injections of factor VIII/IX together with intravenous IgG and cyclophosphamide. In order to increase the production of antigen-antibody complexes, and also to improve cost-efficacy, we applied continuous infusion instead of intermittent injection in 5 high-responders (3 hemophilia A and 2 hemophilia B). All treatment attempts failed. However, we conclude that continuous infusion may play a role in immune tolerance induction, and the treatment failures in our study could probably be explained by the fact that the patients were partially selected to be resistant cases.
Berntorp
E
E
Department of Coagulation Disorders, University of Lund, Malmö University Hospital, Sweden. erik.berntorp@medforsk.mas.lu.se
D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage; D004338:Drug Combinations; D005164:Factor IX / Q000008:administration & dosage / Q000276:immunology; D005167:Factor VII / Q000008:administration & dosage; D005169:Factor VIII / Q000008:administration & dosage* / Q000276:immunology; D006467:Hemophilia A / Q000188:drug therapy / Q000276:immunology; D002836:Hemophilia B / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance; D007074:Immunoglobulin G / Q000008:administration & dosage; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D007262:Infusions, Intravenous; D007267:Injections; D007518:Isoantibodies / Q000097:blood
D004338:Drug Combinations; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D007518:Isoantibodies; D003520:Cyclophosphamide; D005167:Factor VII; D005169:Factor VIII; D005164:Factor IX