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After exposure to factor VIII (FVIII), about one third of patients with severe hemophilia develop antibodies (inhibitors), and most become resistant to further treatment with FVIII. Patients who are inhibitor free after exposure in early childhood are considered tolerant to FVIII. To examine whether this tolerance persists throughout life — now that patients with hemophilia are living longer (JW Oncol Hematol Aug 14 2007) — investigators calculated the incidence of new FVIII inhibitors in all 2528 patients with severe hemophilia registered in the UK National Haemophilia Database between 1990 and 2009.
Of 315 patients who developed new inhibitors, 155 (49%) were children aged <5 years; incidence of new inhibitors was highest in this age group…