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Failure of rituximab to induce immune tolerance in a boy with severe haemophilia A and an alloimmune factor VIII antibody: a case report and review of the literature

Lookup NU author(s): Dr Tina Biss, Dr Mark Velangi, Dr John Hanley

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Abstract

We report the use of rituximab (MabThera((R)); Roche Grenzach-Wyhlen, Germany) in a 6-year-old boy with severe haemophilia A and a high titre alloimmune factor VIII (FVIII) antibody, which had failed to respond to standard immune tolerance therapy. Rituximab was administered in 4 weekly doses with concurrent high-dose i.v. immunoglobulin (Flebogamma((R)); Grifols, Barcelona, Spain) followed by daily high-dose recombinant FVIII concentrate (Recombinate((R)); Baxter, CA, USA). Despite a fall in CD20 positive cell count to undetectable levels the inhibitor persisted. We discuss the possible reasons for failure of immune tolerance induction and review the literature concerning the use of rituximab for this indication.

Publication metadata

Author(s): Biss TT, Velangi MR, Hanley JP

Publication type: Article

Publication status: Published

Journal: Haemophilia

Year: 2006

Volume: 12

Issue: 3

Pages: 280-284

ISSN (print): 1351-8216

ISSN (electronic): 1365-2516

Publisher: Wiley-Blackwell Publishing Ltd.

URL: http://dx.doi.org/10.1111/j.1365-2516.2006.01212.x

DOI: 10.1111/j.1365-2516.2006.01212.x

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