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A Multicenter US Experience

Doreen B. Brettler, MD; Ann D. Forsberg, MS; Peter H. Levine, MD; Louis M. Aledort, MD; Margaret W. Hilgartner, MD; Carol K. Kasper, MD; Jeanne M. Lusher, MD; Campbell McMillan, MD; Harold Roberts, MD

Arch Intern Med. 1989;149(6):1381-1385.

Abstract
• The response to a highly purified concentrate of porcine factor VIII was evaluated in 45 bleeding episodes in 38 patients with high responding inhibitor antibodies to factor VIII. A total of 437 infusions were given. The patients came from 25 hemophilia centers in the United States. The majority had a life- or limb-threatening hemorrhage for which other modalities had not been successful. In 32 of 45 episodes, a good to excellent response was obtained. Adverse reactions were minimal, occurring in 17 treatment episodes, and were mostly treated with antihistamines and/or hydrocortisone. No clear predictor of clinical response to porcine factor VIII concentrate was identified, including pretreatment human and porcine inhibitor levels, percentage of cross-reactivity between the human and porcine antibodies, and the presence of measurable levels of factor VIII after the porcine factor concentrate was given. Anamnesis to porcine factor VIII did occur in some instances. Porcine factor VIII is a valuable modality in the treatment of serious hemorrhages in patients with inhibitors to factor VIII. Its use should be considered early in the course of severe hemorrhage in these patients.

(Arch Intern Med. 1989;149:1381-1385)

Author Affiliations
From the New England Area Comprehensive Hemophilia Center and Department of Medicine, The Medical Center of Central Massachusetts—Memorial, Worcester (Drs Brettler and Levine and Ms Forsberg); Mount Sinai Medical Center, New York, NY (Dr Aledort); Cornell Medical Center, New York (Dr Hilgartner); Orthopedic Hospital, Los Angeles, Calif (Dr Kasper); Children's Hospital of Michigan, Detroit (Dr Lusher); and Department of Medicine and Pediatrics, University of North Carolina, Chapel Hill (Drs McMillan and Roberts).

Footnotes
Accepted for publication February 28, 1989.

Reprint requests to Hematology Clinic, The Medical Center of Central Massachusetts—Memorial, 119 Belmont St, Worcester, MA 01605 (Dr Brettler).

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