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Andreas Tiede1, Sophie Susen2, Ton Lisman3

  • 1Department of Haematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.

Haemophilia : the Official Journal of the World Federation of Hemophilia
|April 2, 2024
PubMed
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Recent advances offer new hope for acquired bleeding disorders. Acquired hemophilia A (AHA) can be managed with emicizumab, while acquired von Willebrand syndrome (AVWS) and chronic liver disease (CLD) bleeding require tailored approaches.

Area of Science:

  • Hematology
  • Internal Medicine
  • Thrombosis and Hemostasis

Background:

  • Acquired bleeding disorders, including acquired hemophilia A (AHA), acquired von Willebrand syndrome (AVWS), and hemostatic abnormalities in chronic liver disease (CLD), affect individuals regardless of age or gender.
  • These conditions are often linked to specific underlying pathologies, necessitating specialized management strategies.

Approach:

  • This review explores recent advancements in managing AHA, AVWS, and bleeding complications in CLD.
  • It highlights novel therapeutic options and discusses the complexities of current treatment paradigms.

Key Points:

  • Emicizumab, a factor VIII bypassing agent, offers a new prophylactic option for AHA patients.
  • Managing AVWS remains complex, demanding individualized treatment based on the specific clinical context.
Keywords:
coagulation factor deficienciesfactor VIIIliver diseasevon Willebrand factor

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  • Hemostatic abnormalities in CLD are often compensated, with bleeding rarely stemming from hemostatic failure; plasma or factor concentrates may be ineffective.

    • Conclusions:

    • The landscape of acquired bleeding disorder management is evolving, with targeted therapies emerging for specific conditions like AHA.
    • Effective treatment for AVWS and CLD-related bleeding requires a nuanced understanding of the hemostatic system's compensatory mechanisms and underlying disease processes.