Therapy of coagulation factor VIII autoantibodies with long-term extracorporeal protein A adsorption and immunosuppression.

Abstract Acquired factor VIII (FVIII) inhibitors in non-haemophiliacs may pose serious treatment problems. Materials and Methods: For IgG-adsorptions we utilized an automated plasma separation device and a plasma flow monitor. Case reports: 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.