Therapeutic Use of Factor VIII

To the Editor: We agree with Skinner and Schwartz1 that cautious interpretation of the results of immunosuppressive therapy in patients with anti-factor VIII antibodies is justified. However, to suggest that massive doses of concentrated factor VIII alone will more than temporarily control such circulating anticoagulants is unwarranted. In the report on which this statement was based,2 the inhibitor noted in two of three patients completely disappeared after combined therapy with both factor VIII concentrate and azathioprine. The third, a 72-year-old hemophilic patient, had an unusual inhibitor in that factor VIII and inhibitor were simultaneously present prior to therapy. The disappearance.