Summary
In a retrospective study 51 published cases of post-partum factor VIII inhibitors
were analyzed with regard to the outcome according to treatment. The overall outcome
was favorable with 97% survival at two years. The probability of complete remission
(CR, absence of the inhibitor and normalization of factor VIII activity) was almost
100% at 30 months. Steroid treatment appears to be not superior to no treatment, but
patients treated with immunosuppressive drugs (cyclophosphamide, azathioprine, 6-mercaptopurine)
had a significantly shorter time to CR. In the absence of a randomized trial this
analysis may be helpful for decision-making in women with factor VIII post-partum
inhibitors. Because of the retrospective study design, conclusions have to be regarded
with caution.