Successful treatment of acquired von Willebrand syndrome associated with monoclonal gammopathy : Breaking a dangerous bond.

Wien Klin Wochenschr

Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.

Published: June 2022

AI Article Synopsis

  • Acquired von Willebrand syndrome is a rare form of von Willebrand disease, making up only 1-3% of cases; this report discusses two patients with this condition linked to monoclonal gammopathy.* -
  • Both patients achieved complete remission of acquired von Willebrand syndrome following intensive antimyeloma treatments, demonstrating the effectiveness of aggressive therapies.* -
  • Treatment strategies included a variety of drugs, with one patient successfully managed with a multi-drug regimen while the other underwent autologous stem cell transplantation, leading to normalized coagulation studies.*

Article Abstract

Acquired von Willebrand syndrome is exceedingly rare and accounts for only 1-3% of von Willebrand disease cases. In this short report, we present our own cases of acquired von Willebrand syndrome associated with monoclonal gammopathy. Both cases went into complete and sustained remission after intensive antimyeloma treatment. The first patient was not deemed fit for autologous stem cell transplantation and was managed with an extensive multidrug combination including daratumumab, carfilzomib, lenalidomide, cyclophosphamide and dexamethasone. After at least VGPR was achieved the coagulation studies rapidly normalized and remained normal after treatment de-escalation to lenalidomide/dexamethasone maintenance. The second patient successfully underwent ASCT after 5 cycles of induction with daratumumab, bortezomib, cyclophosphamide and dexamethasone and has remained in full hematologic and hemostaseologic remission ever since.The two cases highlight the efficacy of aggressive antimyeloma treatment in monoclonal gammopathy-associated acquired von Willebrand syndrome to achieve normalization of coagulation study, providing a possible way to manage these patients.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9213330PMC
http://dx.doi.org/10.1007/s00508-022-02012-3DOI Listing

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