K. Derfler, Extracorporeal immunoadsorption for the treatment of haemophilic patients with inhibitors to factor VIII or IX, VOX SANGUIN, 77, 1999, pp. 57-64
Background and Objectives: This article reviews the relevance of immunoadso
rption in the treatment of haemophilic patients with inhibitors. Materials
and Methods: Immunosorba (sepharose-bound staphylococcal protein A) and Ig-
Therasorb (sepharose-bound polyclonal sheep antibodies to human immunoglobu
lin) columns are suitable for the clinical use of immunoadsorption. They al
low the processing of large plasma volumes (>7,000 mi) without relevant sid
e-effects, Results: A haemophilic patient was treated with the Malmo protoc
ol, another was admitted with intracerebral bleeding. Immunoadsorption redu
ced the inhibitor titer by 70-90%, Conclusions: Immunoadsorption can be use
d in cases of acute bleeding, before surgery, acquired factor VIII (FVIII)
antibodies, and before the start of immune tolerance therapy. We suggest th
e inclusion of this method in immune tolerance protocols in order to improv
e levels, recovery, and half-life of FVIII and to save concentrates.