Dr. Kasper has collaborated with Dr. Tom E. Howard of Veterans’ Hospital on an NIH-funded project to investigate the causes of the high incidence of inhibitors in hemophilia patients of black African descent. Black patients have twice the inhibitor rate of white patients. The current study is looking at genetic aspects of factor VIII structure and of the immune system in hundreds of hemophilia A patients from the USA, Canada and South Africa, with the co-operation of many hemophilia centers who have drawn blood samples from their patients for us. A current hypothesis that is under investigation is that a slightly-modified recombinant factor VIII might be tolerated better by black patients, a version of “personalized medicine” in the bleeding disorders field. The researchers next will examine the increased incidence of inhibitors in Hispanic patients.