Incidence and survival of cancers among 1,054 hemophilia patients: A nationwide and 14‐year cohort study

Abstract

As life expectancy increases in persons with hemophilia (PWH), more age-related diseases such as cancer emerge among this patient group. The aim of this study was to investigate incidence and survival of cancers among PWH in Taiwan. We analyzed data of 1,054 PWH retrieved from Taiwan's National Health Insurance Research Database between 1997 and 2010, by comparing variables to 10540 age-and gendermatched healthy individuals from the general population. There were 43 PWH and 178 individuals of general population with newly diagnosed cancer (RR 2.42, 95% CI 1.74-3.35). The cumulative incidences of cancer in PWH and the general population were 4.7 and 1.9%, respectively. Hepatocellular carcinoma (HCC) was the major type of cancer (17 cases) in PWH; cancer rate was still increased when HCC and HIV-related cancers were excluded (RR 1.66, 95% CI 1.06-2.59). There was no significant difference observed in lung, colorectal, or prostate cancer occurrence. Compared to the general population, PWH were younger at the time of cancer diagnosis (45.1 vs. 57.2 years old, P value < 0.001), and had fewer co-morbidities. Nineteen PWH with cancers died during the study period, and no bleeding-related death was recorded among these patients. The survival rate was not different between PWH and the general population, P 5 0.86. In conclusion, the cumulative incidence of cancer among PWH was higher than the general population. PWH with cancer were younger and had fewer comorbidities, but the survival rates were similar in the two groups.Am. J. Hematol. 90:E55-E59,

Surgery in a Patient with Haemophilia A and Lymphoma

“…For other pdFVIII products, similar data have been reported: loading 2 Case Reports in Hematology doses ranged from 25-200 IU/kg, mean doses per ED were 50-70 IU/kg, and treatment for up to 10 days was common [6][7][8][9]. An increased incidence of haematologic malignancies and other cancer types among patients with haemophilia compared with matched controls has been reported in several longitudinal studies [10,11]. Close follow-up for malignancies in these patients is therefore recommended [11].…”

Gastric Cancer, Hemophilia A and Angiodysplasia - An Unreported Association with Clinical Implications in a Patient with Digestive Hemorrhage

“…The incidence of malignancies in patients with hemophilia is higher, compared with general population, but most patients have virus-related cancers (22)(23)(24), because prevalence of hepatitis B, C and human immunodeficiency virus infection is higher, compared with the general population (23). Thus, hepatocellular carcinoma, leukemia and lymphoma are the most frequent types of cancers in patients with hemophilia (23,24).…”

“…However, surgery of malignant tumors in patients with hemophilia is associated with increased risk of postoperative complications, including bleeding, despite proper replacement therapy (27). Nevertheless, it appears that associated hemophilia does not have a detrimental effect on long-term prognosis of treated malignancies (23).…”

A hemophilic patient presented with an abdominal mass, fever and cough

“…Prophylaxis and early treatment with FVIII concentrate that is safe from viral contamination have dramatically improved the prognosis of patients with severe hemophilia. Nevertheless, approximately one quarter of patients with severe hemo- 46 showed that among six PWH with leukemia, four had acute lymphoblastic leukemia and two had acute myeloid leukemia.…”