RADIOACTIVE SYNOVIORTHESIS IN PATIENTS WITH HEMOPHILIA WITH FACTOR INHIBITOR

In nine patients with hemophilia and factor inhibitor (six with hemoph ilia A; three with hemophilia B), 19 joints were treated with radioact ive synoviorthesis using Au-198, Ages ranged from 3 to 40 years, Synov iorthesis was performed when the antibody titer was low (< 10 Bethesda units), thus making hemostasis possible by factor administration for 2 to 4 days, On five occasions, radioactive synoviorthesis was perform ed simultaneously with tolerance induction according to the Malmo prot ocol, A bleeding free interval of more than 6 months was obtained in 1 1 joints, six of which remained bleeding free for more than a year, At long term followup (range, 18-182 months) five joints were rated good , one joint was fair, and 11 joints were poor, Although the results ar e inferior to those for patients with hemophilia without inhibitor, ra dioactive synoviorthesis should be considered because of its ease of p erformance and the definite decrease in joint bleeding frequency that it brings about, This is of particular interest in patients with hemop hilia caused by factor inhibitor who otherwise are difficult to treat.