Immune tolerance induction: recombinant vs. human-derived product.

The ultimate goal in the treatment of high-responding inhibitors in congenital haemophilia is to induce immune tolerance (IT). Since the advent of highly purified factor VIII products, especially recombinant ones, the issue has been raised of whether the type of product has an impact on treatment success. It is clear that IT induction is possible to achieve with both recombinant products and human-derived products, but there is a lack of comparative studies. Different theoretical aspects indicate that human-derived concentrate, especially of low purity, and with a high content of von Willebrand factor, may have a better tolerizing effect.