Abstract Number: PB0446
Meeting: ISTH 2021 Congress
Background: Acquired hemophilia A (AHA) has been described in elderly patients, pregnancy, puerperium, autoimmune disorders and associated to cancer. Some reviews report AH after drugs. We present a case of AHA secondary to chemotherapy, oxaliplatin and capecitabine, a 62-year-old female, who in May 2010 was admitted with septic shock due to perforated sigmoid colon tumor, multi-organ failure and activated partial thromboplastin test (APTT) 43.9 (normal 23.6-35.0 seconds). She received fresh frozen plasma and cryoprecipitate with improvement. Laparotomy with colostomy was made and biopsy reported: moderately differentiated T3 sigmoid adenocarcinoma, N1a, which invaded to pericolic adipose and lymphovascular tissue, surgical margins free of neoplasm, positive lymph nodes: 1 of 13. Computed tomography (CT) without signs of secondary spread. The oncology committee decides to administer chemotherapy, XELOX, oxaliplatin and capecitabine, she received 3 cycles. Three weeks after the last cycle, she presented spontaneous bruising and ecchymoses in the extremities, doppler eco: myofascial tear between soleus and gastrocnemius with hematic collection in lower right limb. APTT: 57.4 seconds without correction, Factor VIII 3% (normal 50-150%) and FVIII inhibitor titer 8 BU. She was treated with prednisone 1 mg/kg/day and cyclophosphamide 1.5 mg/kg/day, for 4 weeks, together with activated recombinant Factor VII 90µg/kg every 6 hours/1 day, then due to low availability of agents, activated prothrombin complex concentrate was indicated, doses: 62 U/kg/day, for 4 days. She had good clinical and laboratory evolution. A new CT scan and bone scintigraphy were performed without evidence of neoplasia; because of this we think that she had an AHA secondary to chemotherapy, oxaliplatin and capecitabine and that situation has not been reported.
Aims: Present a acquired hemophilia case report.
Methods: Review of clinical and laboratory date.
Results: We are presenting an acquired hemophilia induced by chemotherapy.
Conclusions: We have an hemophilia acquired secondary to chemotherapy, oxaliplatin and capacitabine, no reported so far.
To cite this abstract in AMA style:Mijares M, Pena K, Carmona L, Vega V, Puente L, Aranda S. Acquired Hemophilia after Chemotherapy: Oxaliplatin and Capecitabine, a Case Report [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/acquired-hemophilia-after-chemotherapy-oxaliplatin-and-capecitabine-a-case-report/. Accessed September 29, 2023.
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