Treatment of hemophilia A with factor VIII inhibitors

Factor VIII inhibitor was found in 25 of the 185 patients with severe haemophilia A (13.5%). Periodic assay of the inhibitor in haemophiliacs is of the utmost importance for on early detection of this comolication. Replacement therapy in patients with factor VIII inhibitor should be limited to the major bleeding episodes with adequate doses of concentrates. The anamnestic response following replacement therapy varies from one patient to the other and can be roughly predicted. The use of cyclophosphamide has been shown to inhibit the anamnestic response in some cases: one of the administration schedules used in this work can be proposed for a further clinical trial.