Document Detail

The North American Immune Tolerance Registry: practices, outcomes, outcome predictors.
MedLine Citation:
PMID:  11848456     Owner:  NLM     Status:  MEDLINE    
The North American Immune Tolerance Registry was initiated to study of immune tolerance (ITT) in Canada and the United States with respect to: 1) therapeutic regimens in use for haemophilia A (HA) and B (HB) inhibitor patients; 2) therapeutic outcomes; 3) potential predictors of successful outcome and 4) complications of therapy. Data on 188 ITT courses was collected by questionnaire from 60 haemophilia centers from 1993-99. Among the completed courses, the overall success rate was 70% (115/164) for all HA and 31% (5/16) for all HB. Outcome parameters noted to be predictive of ITT success for all HA were 1) pre-ITT induction (p = 0.003), 2) ITT peak (p = 0.007) and 3) historical pre ITT peak (p = 0.04) inhibitor titres. An inverse correlation between total daily dose (units/kg/day) and success: (80% with under 50; 71% with 50-99; 73% with 100-199; and 41% with > or = 200, p = 0.01) was found. Outcome predictors were not evaluable for HB, although adverse reactions to therapy, including nephrotic syndrome, and access complications were more common among failed courses. Infection most often complicated the use of access catheters. These results are discussed within the context of the international ITT registry and upcoming prospective ITT study.
D M DiMichele; B L Kroner;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Thrombosis and haemostasis     Volume:  87     ISSN:  0340-6245     ISO Abbreviation:  Thromb. Haemost.     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2002-02-18     Completed Date:  2002-08-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7608063     Medline TA:  Thromb Haemost     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  52-7     Citation Subset:  IM    
New York Presbyterian Hospital, Weill Medical of College of Cornell, New York 10021, USA.
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MeSH Terms
Canada / epidemiology
Catheterization, Central Venous / adverse effects
Cohort Studies
Desensitization, Immunologic* / statistics & numerical data,  utilization
Factor IX / immunology*,  therapeutic use
Factor VIII / immunology*,  therapeutic use
HIV Infections / epidemiology,  immunology
Hemophilia A / epidemiology,  immunology*,  therapy
Hemophilia B / epidemiology,  immunology*,  therapy
Hemorrhage / etiology
Immune Tolerance*
Isoantibodies / blood,  immunology*
Outcome Assessment (Health Care)
Recombinant Proteins / immunology,  therapeutic use
Registries / statistics & numerical data*
Retrospective Studies
Treatment Outcome
United States / epidemiology
Reg. No./Substance:
0/Isoantibodies; 0/Recombinant Proteins; 9001-27-8/Factor VIII; 9001-28-9/Factor IX

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