POSTPARTUM FACTOR-VIII INHIBITORS - A REVIEW OF THE LITERATURE WITH SPECIAL REFERENCE TO THE VALUE OF STEROID AND IMMUNOSUPPRESSIVE TREATMENT

In a retrospective study 51 published cases of post-partum factor vm i nhibitors were analyzed with regard to the outcome according to treatm ent. The overall outcome was favorable with 97% survival at two years. The probability of complete remission (CR, absence of the inhibitor a nd normalization of factor Vm activity) was almost 100% at 30 months. Steroid treatment appears to be not superior to no treatment, but pati ents treated with immunosuppressive drugs (cyclophosphamide, azathiopr ine, 6-mercaptopurine) had a significantly shorter time to CR. In the absence of a randomized trial this analysis may be helpful for decisio n-making in women with factor VIII post-partum inhibitors. Because of the retrospective study design, conclusions have to be regarded with c aution.