Acquired factor VIII inhibitor treated with cyclophosphamide, vincristine, and prednisone

Life-threatening bleeding can occur in non-hemophiliacs with factor VIII inhibitor and is difficult to control. Various methods have been used to suppress the inhibitor. Since 1993 we treated 6 non-hemophilic patients with factor VIII inhibitor with cyclophosphamide, vincristine, and prednisone (CVP) every 3-4 weeks. Five had complete response with disappearance of factor VIII inhibitor and normalization of factor VIII after 1 to 7 cycles of CVP. One patient did not respond after 4 cycles of CVP; mitoxantrone was added to additional two cycles of CVP, and the inhibitor disappeared.