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Use of porcine factor VIII in the treatment of patients with acquired
hemophilia
AE Morrison, CA Ludlam and C Kessler
Department of Haematology, Royal Infirmary, Edinburgh, UK.
Data have been collected from 47 centers in Europe and North America on the
treatment with porcine factor VIII concentrate of 74 acute bleeding
episodes in 65 patients with acquired hemophilia. The median initial
anti-human factor VIII auto-antibody inhibitor level was 38 Bethesda unit
(BU)/mL (range 1.2 to 1,024) whereas that against porcine was 1 BU/mL
(range 0 to 15). The mean initial dose of porcine factor VIII infused was
84 IU/kg, which increased the plasma factor VIII:C activity by 0.85 IU/mL.
Therapy was continued for a mean of 8.5 days during which time the average
number of infusions was 11. Objective clinical responses were rated as good
or excellent in 78% of recipients. Side effects were uncommon; only one
patient experienced a severe anaphylactic reaction necessitating the
discontinuation of porcine FVIII therapy. After therapy, no increase in the
median level of anti- human FVIII or anti-porcine antibody was noted in the
group as a whole, although 13 patients showed individual increases in
either anti-human or anti-porcine antibody levels or both of more than 10
BU/mL. Of the 7 patients who subsequently rebled, 5 were successfully
re-treated and 2 did not respond to further porcine factor VIII treatment.
Porcine factor VIII is safe and clinically effective treatment for bleeding
episodes associated with acquired hemophilia and should be considered as
first-line therapy for patients whose acquired anti-factor VIII:C antibody
cross-reacts with porcine factor VIII:C at low levels.
Volume 81,
Issue 6,
pp. 1513-1520,
03/15/1993
Copyright © 1993 by The American Society of Hematology
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