Young hemophilic patients, inhibitors and immune tolerance

The occurrence of inhibitor in a hemophilic patient is the greatest therape utic complication in 1999. The inhibitor incidence is higher in hemophilia A (20-30 %) than in hemophilia B (3 %). At the moment, the best management is immune tolerance induction. This consists in frequent infusion of antihe mophilic factor (every day or every other day). The risk of inhibitor devel opment is higher in a young child than in an adult. Consequently, a venous access device is essential for this treatment although not devoid of compli cations in the young boy. Moreover, the probability of inhibitor dissappear ance is higher in a child (recent inhibitor) than in an adult ("old" inhibi tor). (C) 1999, Elsevier, Paris.