Extracorporeal immunoadsorption for the treatment of haemophilic patients with inhibitors to factor VIII or IX

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.