2003; baxter - Supplements - Haematologica

eview paperForewordHANS-HERMANN BRACKMANNhaematologica 2003; 88(suppl. n. 12):1http://www.haematologica.org/free/immunotolerance2001.pdfThe 4 th International Workshop on Immune Tolerancewas held in August 2001 in Bonn-Königswinter, Germany and attracted approximately160 participants to share and discuss themost burning and unresolved issues related toinhibitor treatment in hemophilia. To host all participantsin Königswinter was a particular honourbecause the same year the Hemophilia Center inBonn celebrated its 30 th anniversary.Looking back into the history of hemophiliatreatment we have to recognize that it took a verylong time to understand the pathophysiology ofhemophilia and to develop a diagnostic methodsuch as a simple clotting test.With the increasing knowledge in coagulation,treatment could rapidly be developed. Nowadayssafe products are available and treatment scheduleshave been established; however, development ofinhibitors remains a major challenge.We know that genetic defect and factor exposuredays play a role in the development ofinhibitors, we know how to induce immune tolerancein some of our patients using specific treatmentprotocols. Nevertheless many questions stillremain to be answered, in particular as regards ourunderstanding of the mechanism of inhibitordevelopment. We should therefore focus ourefforts on the most important questions, forinstance the question why some patients developinhibitors, why others do not, why immune toleranceis successful in some patients and in somenot. Researchers and hemophilia treaters all overthe world are working hard to find those answers.The agenda of this meeting focused on immunologicaltopics in association with hemophilia andinhibitors in order to provide an understanding ofcurrent concepts and new approaches.The 4th International Workshop was placedunder the same motto that is inscribed at the baseof the Statue of Liberty, welcoming people from allover the world with the promise of freedom, whichwe would also like to give to all our patients: «Giveme your tired, your poor, your huddled masses, yearningto be free».Hans-Hermann BrackmannAcknowledgmentsI am grateful to all speakers and authors whohave contributed to this supplement which providesvaluable information for researchers, healthcareprofessionals and caregivers dedicated tohemophilia issues and hemophilia patients.I wish also to thank all my co-workers who havedone their best to make this workshop successful.Last but not least I would like to thank my friendGuglielmo Mariani for the partnership in thisworkshop and his exceptional friendship.This publication was made possible by an educationalgrant provided by Baxter BioScience.haematologica vol. 88(supplement n. 12):september 2003