Thromb Haemost 1999; 82(03): 1005-1007
DOI: 10.1055/s-0037-1614318
Letters to the Editor
Schattauer GmbH

Solid Tumors and Factor VIII Antibodies

Irene Hauser
1   From the Division of Hematology/Blood Coagulation, I. Department of Internal Medicine, University of Vienna, Austria
,
Klaus Lechner
1   From the Division of Hematology/Blood Coagulation, I. Department of Internal Medicine, University of Vienna, Austria
› Author Affiliations
Further Information

Publication History

Received 23 February 1999

Accepted after revision 04 May 1999

Publication Date:
09 December 2017 (online)

Summary

Purpose: To analyze the association between solid tumors and the occurrence of factor VIII antibodies and the response to treatment.

Patients and Methods: Published case reports describing the association of a solid tumor and a factor VIII antibody retrieved from 20 data bases. 40 cases were reported and 27 cases were analyzable.

Results: Factor VIII antibodies occurred in a close temporal relationship with the detection of the tumor in most cases. No association with a specific type of tumor could be identified. Immune suppressive treatment with prednisone ± cyclophosphamide was successful in the majority of cases.

Conclusion: It is likely that there is a causal association between some solid tumors and factor VIII antibodies, but it is an extremely rare complication of cancer. The immunoglobuline nature of the inhibitor and the good response to immune suppressive treatment suggests that it is an autoimmune phenomenon. The pathogenesis is unknown.

 
  • References

  • 1 Green D, Lechner K. A survey of 215 non-hemophilic-patients with inhibition to factor VIII. Thromb Haemost 1981; 45: 200-3.
  • 2 Al-Ismail SAD, Parry DH, Moisey CU, Bloom AL. Factor VIII inhibitor and bronchogenic carcinoma. Thromb Haemost 1979; 41: 291-5.
  • 3 Allain JP, Gaillandre A, Frommel D. Acquired Haemophilia: Functional study of antibodies to factor VIII. Thromb Haemost 1981; 45: 285-9.
  • 4 Bona RD, Ribeiro M, Klatsky AU, Panek S, Magnifico M, Rickles FR. Continuous infusion of porcine factor VIII for the treatment of patients with factor VIII inhibitor. Semin Hematol 1993; 30: 32-5 (Suppl. 01)
  • 5 Brodeur GM, O’Neill PJ, Wilimas JA. Acquired inhibitor of coagulation in nonhemophiliac children. J Pediatr 1980; 96: 439-41.
  • 6 Clyne LP, Levy A, Stein S, McPhedran P. A high titre “spontaneous” porcine FVIII inhibitor. Thromb Haemost 1992; 68: 475.
  • 7 Colovic DM, Jankovic MG, Suvajdzic N, Colovic R. Inhibitors to factor VIII : C in nonhemophiliacs. Am J Hematol 1996; 52: 61.
  • 8 De Cataldo F, Baudo F, Redaelli R, Pezzetti L. Acquired factor VIII: C inhibitor (IgG) and positive direct Coombs’test (IgM) in a patient with lung carcinoma. Scand J Haematol 1984; 33: 171-6.
  • 9 Green D, Rademaker AW, Briet E. A prospective, randomized trial of prednisone and cyclophosphamide in the treatment of patients with factor VIII autoantibodies. Thromb Haemost 1993; 70: 753-7.
  • 10 Heyd R, Kirchner J, Kollath J. Böttcher Acquired factor VIII inhibitor haemophilia in advanced cervical carcinoma. Erworbene Faktor VIII-Hemmkörperhämophilie beim fortgeschrittenen Zervixkarzinom. Tumordiagn u Therapie 1995; 16: 242-5.
  • 11 Hultin MB. Acquired inhibitors in malignant and nonmalignant disease states. Am J Med 1991; suppl 5A 9S-13S.
  • 12 Kondo Hideki, Shigekiyo T, Kojima A, Saito S, Saijo N. Acquired VIII inhibitor in a patient with adenocarcinoma of the lung. Jpn J Clin Oncol 1992; 22: 49-53.
  • 13 Lauritsen K, Madsen PER. Factor VIII inhibitor ved cancer pancreatis. Ugeskr Laeger 1981; 143: 1541.
  • 14 Letizia C, Sellini M, Avvisati G, Scavo D. Acquired factor VIII inhibitor in a patient with adenocarcinoma of the colon-rectum. Ital J Gastroenterol 1991; 23: 88-9.
  • 15 Lionnet F, Pulik M, Genet P, Lucas G, Sollet JP. Acquired factor VIII inhibitor associated with a prostatic cancer: simultaneous occurence and healing. Thromb Haemost 1995; 73: 327-8.
  • 16 Liozon E, Delaire L, Turlure P, Jaccard A, Loustaud Ratti V, Remenieras L, Julia A, Gaillard S, Bordessoule D, Vidal E. Hémophilie acquise par autoanticorps dirigé contre l’activité coagulante du facteur VIII. Étude clinique biologique et indications thérapeutiques. Expérience à partir d’une étude de 9 cas. Ann Med Interne 1997; 148: 477-90.
  • 17 Lopez R, Mateo J, Cruz J, Lopez A, Urrutia T, Fontcuberta J. Presentation of an acquired factor VIII inhibitor with a muscular haematoma mimicking a deep venous thrombosis in a patient with breast cancer. Blood Coagul Fibrinolysis 1995; 6: 680-2.
  • 18 Lottenberg R, Kentro TB, Kitchens CS. Acquired hemophilia. A natural history study of 16 patients with factor VIII inhibitors receiving little or no therapy. Arch Intern Med 1987; 147: 1077-81.
  • 19 Louthrenoo W, Abrahm J, Schumacher HR. Hemarthrosis in patients with acquired factor VIII inhibitor. J Rheumatol 1991; 18: 104-5.
  • 20 Moore MR, Poon MC, Williams RB, McDonald CR. Acquired inhibitor to factor VIII (AHF) occuring with squamous cell carcinoma of the tongue. J Lab State Med Soc 1982; 134: 23-4.
  • 21 Morrison AE, Ludlam CA, Kessler C. Use of porcine factor VIII in the treatment of patients with acquired hemophilia. Blood 1993; 81: 1513-20.
  • 22 Neilson RF, Walker ID, Roberson M. Factor VIII inhibitor associated with hepatocellular carcinoma. Clin Lab Haematol 1993; 15: 145-8.
  • 23 Nilsson IM, Lamme S. On acquired hemophilia A. Acta Med Scand 1980; 208: 5-12.
  • 24 Orth T, Schnuetgen M, Herr W, Mayet WJ, Dippold W, Wanitschke R, Meyer zum Buschenfelde KH. Acquired factor VIII : C inhibitor associated with adenocarcinoma of the prostate in a 75-year old man successfully treated with porcine factor VIII. Prostatakarzinom-assozierte spontane Hemmkörperhämophilie. Erfolgreiche Therapie einer schweren Blutungskomplikation mit porzinem Faktor VIII bei einem 75jährigen Patienten. Med Klin 1997; 92: 241-5.
  • 25 Parracchini ML, Rocchini GM, Renoldi GM, Fiorini GF, Gosso P, Onida L, Geniram A, Marini U, Gibelli A. Acquired factor VIII inhibitor in a non-haemophilic patient: successful treatment with plasma exchange associated with factor VIII concentrate and immunosuppressors. Haemostasis 1984; 14: 249-52.
  • 26 Preminger GM, Knupp CL, Hindsley JP, Jenkins JM, Fried FA, Blatt PM. Spontaneously acquired antifactor VIII antibodies: report of a patient with adenocarcinoma of the prostate. J Urol 1984; 131: 1182-4.
  • 27 Rhodes EGH, Boesen EA, Corringham RET, Matthews KB, Tuddenham EGD, Kernoff PBA. Disappearance of antibodies to factor VIII in a patient with acquired haemophilia and carcinoma of the pancreas during cytotoxic therapy with fluorouracil and CCNU. Thromb Haemostas 1984; 52: 131-3.
  • 28 Shastri KA, Logue GL, Zeid MY, Behrens AN, Lenahan EJ, Haar JG. Acquired factor VIII inhibitor with squamosous cell cancer of the epiglottis. Arch Otolaryngol Head Neck Surg 1990; 116: 350-3.
  • 29 Shurafa M, Raman S, Wollner I. Disappearance of factor VIII antibody after removal of primary colon adenocarcinoma. Am J Hematol 1995; 50: 149-50.
  • 30 Singal U, Mammen EF. Concomitant occurence of disseminated intravascular coagulation and factor VIII inhibitor in a patient with prostatic cancer. Am J Hematol 1987; 25: 237-42.
  • 31 Sultan I, Kazatchkine M, Nydegger U, Rossi F, Dietrich G, Algiman M. Intravenous immunoglobulin in the treatment of spontaneously acquired factor VIII:C inhibitors. Am J Med 1991; 91: 35-9 suppl 5A
  • 32 Waltke EA, Jakobs SC, Hussey CV, Lawson RK. Massive haematuria due to acquired factor VIII inhibitor. Urology 1981; 18: 601-3.
  • 33 De Vita Jr VT, Hellman S, Rosenberg StA.. Cancer. In: Principles and Practice of Oncology. ed 5. Philadelphia: Lippincott; 1997
  • 34 Weltermann A, Mitterbauer GJ, Mitterbauer M, Hattey E, Speiser W, Gisslinger H, Knöbl P, Eichinger S. Disseminierte intravasale Gerinnung (DIG) und massive Hyperfibrinolyse bei metastasierendem Uteruskarzinom. Beobachtungen über die Beeinflussung der Gerinnungsstörung durch verschiedenen Therapien (ein Fallbericht). Wien Klin Wochenschr 1998; 110: 53-7.
  • 35 Tomer Y, Sherer Y, Shoenfeld Y. Autoantibodies, autoimmunity and cancer (review). Oncol reports 1998; 5: 753-61.
  • 36 Bellone JD, Kunicki TJ, Aster RH. Immune thrombocytopenia associated with carcinoma. Ann Int Med 1983; 99: 470-2.
  • 37 Kim HD, Boogs DR. A syndrome resembling idiopathic thrombocytopenic purpura in 10 patients with diverse forms of cancer. Am J Med 1979; 67: 371-7.
  • 38 Schwartz KA, Slichter SJ, Harker LA. Immune-mediated platelet destruction and thrombocytopenia in patients with solid tumors. Br J Haematol 1982; 51: 17-24.
  • 39 Cummings OW, Mazur MT. Breast carcinoma diffusely metastatic to the spleen. A report of two cases presenting as idiopathic thrombocytopenic purpura. AJCP 1992; 97: 484-9.
  • 40 Gordon PA, Baylis PH, Bird GW. Tumor induced autoimmune haemolytic anemia. BMJ 1967; 1: 1569-70.
  • 41 Spira MA, Lynch EC. Autoimmune hemolytic anemia and carcinoma: an unusual association. Am J Med 1979; 67: 753-8.
  • 42 Wortman J, Rosse W, Logue G. Cold agglutinin autoimmune hemolytic anemia in nonhematologic malignancies. Am J Hematol 1979; 6: 275-83.
  • 43 Patten SF, Dijkstra JWE. Associations of pemphigus and autoimmune disease with malignancy or thymoma. Int J Dermatol 1994; 33: 836-42.
  • 44 Mutasim DF, Pelc NJ, Anhalt GJ. Paraneoplastic pemphigus. Dermatologic Clin 1993; 11: 473-81.
  • 45 Anhalt GJ, Kim SC, Stanley JR. et al. Paraneoplastic pemphigus: an autoimmune mucocutaneous disease associated with neoplasia. N Engl J Med 1990; 323: 1729-35.