Abstract Number: PB0493
Meeting: ISTH 2021 Congress
Background: Haemophilia A is an X-linked bleeding disorder in which the deficiency of coagulation factor VIII (FVIII) results in spontaneous bleeding. Haemophilia A (HA) represents 80% of total patients and it affects 1 in 5,000 male births worldwide. The association with other blood disorders is rare.
An infrequent finding in this type of patients is the development of acute myelogenous leukemia (AML) that is worth reporting, although cases of haemophilia and other malignancies have been reported in HIV-positive subjects, it represents a challenge.
Aims: Report the case of a Mexican patient with mild haemophilia A and acute myeloid leukemia (M2) at the time of presentation.
Methods: A 16-year-old male with known mild haemophilia A with diagnosis at 11 months old with episodic treatment, he received FVIII concentrates twice. He presented with headache, disseminated purpuric lesions, pallor, asthenia and swelling of left temporomandibular joint.
Laboratories revealed haemoglobin 8.9g/dL, total leucocyte count 350,100/mm3, differential count polymorph 0%, lymphocyte 2%, blasts 98%, platelet count 35,000.
Bone marrow smear with 98% myeloid blasts. Immunophenotype: myeloperoxidase 100%, CD13 80.2%, CD33 85.5%, CD117 99%, CD71 90%, HLA/DR 96.2%, CD7 74.7% with diagnosis of acute myeloid leukemia M2.
The patient is receiving chemotherapy according to NOPHO-AML 93 protocol. Previous to any procedure (intrathecal chemotherapy or bone marrow aspiration) the patient received recombinant FVIII concentrate 40UI/Kg without any bleedings.
Conclusions: Haemophilia is a rare disease and associated with AML represents a challenge. Literature has described cases of adult patients with haemophilia who developed HIV-associated malignancies or patients with leukemia developing an acquired hemophilia due to an inhibitor, however, the incidence of leukemia in patients with previous diagnosis of hemophilia and its treatment are important to report. The challenge of treatment because of the risk of bleeding and its complications is important because there is no consensus in the literature.
To cite this abstract in AMA style:Muñoz Juárez Díaz LM, Moreno Gonzalez AM, Velázquez Marmolejo L. Acute Myelogenous Leukemia in a Patient with Mild Haemophilia A. A Case Report at Hospital Infantil de México Federico Gómez [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/acute-myelogenous-leukemia-in-a-patient-with-mild-haemophilia-a-a-case-report-at-hospital-infantil-de-mexico-federico-gomez/. Accessed December 8, 2021.
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