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Cyclophosphamide and Factor VIII Antibodies

Karsten Lauritsen, MD; Poul E. R. Madsen, MD
Arch Intern Med. 1981;141(9):1238-1239. doi:10.1001/archinte.1981.00340090134034.
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To the Editor.  —In the September Archives (1980;140:1232-1235), Green et al reported their long and pioneering experience in treating nonhemophilic patients with blood-clotting factor VIII antibodies using cyclophosphamide. They claimed response in cases with weak inhibitors only. We have seen a patient with a factor VIII antibody of 20 Bethesda units in whom the administration of cyclophosphamide was associated with the disappearance of antibody.

Report of a Case.  —A 51-year-old man without a family or prior personal history of a bleeding disorder experienced a severe hemorrhagic diathesis. Six months previously, an established diagnosis of inoperable carcinoma of the pancreas had been made. He had received no drug therapy or blood transfusion. On hospital admission, the factor VIII coagulant activity was below 2%, and factor VIII inhibitor by the technique of Kasper1 was 20 Bethesda units. Cyclophosphamide treatment, 150 mg/day orally, was begun. Three weeks later, the inhibitor disappeared


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