PB0216 - Cancer in patients with bleeding disorders : a French monocentric retrospective study.

Background: Thanks to scientific progress, the average life expectancy of people with bleeding disorders (BD) increased significantly. The follow-up of these patients becomes particularly tricky with aging, especially when they develop neoplastic diseases, whose incidence is equivalent to the general population’s one.

Aims: During the last decade, Strasbourg University Hospital Haemophilia Treatment Centre (HTC) followed up 297 patients with congenital factor deficiencies, mostly haemophilia A or B, 266 patients with von Willebrand disease and 110 patients with platelet disorders.

Methods: A total of 27 cases of cancers (including 7 with a metastatic location at diagnosis) were included in our study with a median age at diagnosis of 55 years (30 – 80) . Two patients had two separate cancers.

Results: Eleven cancers were identified in women, including 3 breast cancers, 2 glioblastomas, 1 ovarian cancer, 1 sigmoidal adenocarcinoma, 1 mandibular cancer and 3 basal cell carcinomas. Sixteen cancers were identified in men including 6 digestive cancers, 4 liver cancers, 2 prostate cancers, 2 acute myeloblastic leukemias, 1 mandibular and 1 sinus cancer. Cancer was diagnosed for 6 of those patients due to unusual bleedings (increased occurrence or intensity) while two patients were newly diagnosed with BD after cancer. Twenty patients underwent surgical resection with bleeding prophylaxis or thromboprophylaxis because of risk factors. Respectively eleven and seven patients benefited from platelet concentrates because of thrombocytopenia (Eleven patients had chemotherapy and seven radiotherapy with haemostatic replacement). Within this cohort, 9 patients died during the last decade and 16 patients are still alive including 10 in remission with a median duration of 2 years (0,5 to 7 years).

Conclusion(s): Although managing cancer associated to a BD may be complicated, those patients ‘prognosis does not seem modified by BD. We hereby propose to improve the management of cancer in patient suffering from BD with a multicentre epidemiologic trial.