Alloantibodies in von Willebrand disease.

Abstract:

:The development of alloantibodies against von Willebrand factor (VWF) represents a rare but serious complication of treatment of von Willebrand disease (VWD), occurring in ~5% to 10% of type 3 VWD patients. Affected patients can present with a range of symptoms, including lack or loss of hemostatic response to infused VWF concentrates up to anaphylactic reactions in rare cases. It is classically reported in multitransfused patients and occurs most frequently in patients with partial or complete VWF gene deletions. A positive family history of anti-VWF antibodies also appears to be a risk factor. There is a lack of standardization of laboratory methods for antibody identification and characterization. Issues of variability in laboratory approaches as well as the rarity of the complication act as a barrier to future studies. Recombinant factor VIII as well as bypassing agents and immune tolerance have been reported as effective treatments; however, aside from case reports, little exists in the literature to guide management. The imminent clinical availability of recombinant VWF has prompted a resurgence of interest in this area. Additional study is warranted to address the deficiencies in our understanding of this treatment complication.

journal_name

Blood

journal_title

Blood

authors

James PD,Lillicrap D,Mannucci PM

doi

10.1182/blood-2012-10-462085

subject

Has Abstract

pub_date

2013-08-01 00:00:00

pages

636-40

issue

5

eissn

0006-4971

issn

1528-0020

pii

blood-2012-10-462085

journal_volume

122

pub_type

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