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Autoimmune hemophilia (AH), a devastating disorder characterized by recurrent hemorrhages, usually affects older individuals. The disease is caused by autoantibodies that inactivate factor VIII (FVIII), but their intensity, persistence, and sensitivity to immunosuppressive medications is quite variable.
To examine prognostic factors in the treatment of AH, European investigators conducted a multicenter, prospective, observational study involving 102 patients (median age, 74) who were treated with a common protocol that began with prednisolone alone for up to 3 weeks. If FVIII activity failed to rise to >50 IU/dL (partial remission; PR), cyclophosphamide was added during weeks 4 to 6, and rituximab was started in week 7. When PR was achieved,…