Table 1

Summary of cases

ReportAge/sexSymptomsMonths after second alemtuzumab doseAPTT (s)FVIII activityFVIII inhibitor activity (BU/mL)Treatment to control bleedingTreatment to eliminate the inhibitor
Pisa et al546/FAbnormal bruising after minimal trauma: left palm, top of foot, right hand, popliteus haematoma7 Ratio 2.95*1%128Recombinant FVIIaPrednisolone 75 mg and cyclophosphamide 100 mg; following relapse, switched to methylprednisolone and azathioprine
McCaughan et al337/FProgressive right leg pain, swelling, bruising; left arm and thigh non-purpuric masses9 71 (n 24–38)2 U/dL5.7Recombinant FVIIaPrednisolone 1 mg/kg
Madeley et al436/MEasy bruising and epistaxis, then left thigh haematoma48 88<0.01 U/dL7Recombinant FVIIaPrednisolone 1 mg/kg and rituximab
Brink et al642/MExtensive gluteal haematoma12 87<0.1%45Factor VIII bypassing fractionPrednisolone and cyclophosphamide
Gounder et al (current report)48/FSpontaneous bruising over arms and flanks21 85 (n 25–35)<0.02 U/dL51.2Not requiredPrednisolone 75 mg and cyclophosphamide 50 mg
31/FMenorrhagia and easy bruising21 48 (n 22–35)0.22 U/dL1Tranexamic acidPrednisolone 50 mg and cyclophosphamide 50 mg
  • APTT, activated partial thromboplastin time; F, female; FVIII, factor VIII; M, male.