Clinical outcome and cost analyses in adult patients with acquired hemophilia A- a single center, retrospective analysis.

Introduction Acquired hemophilia A (AHA) is a rare, potentially life-threatening bleeding disorder (incidence ~1 per million) caused by autoantibody-mediated neutralization of coagulation factor VIII (FVIII). The resulting loss of FVIII activity markedly impairs thrombin generation and fibrin formation, leading to spontaneous or disproportionate soft-tissue and muscular bleeding. AHA often occurs in association with malignancy, autoimmune disease, or the postpartum period. However, comprehensive real-world data on outcomes, prognostic factors, and the economic burden of AHA management remain limited. Method We retrospectively analyzed 51 adults newly diagnosed with AHA at University Hospital LMU Munich (2011–2023). Diagnosis required clinically relevant bleeding, detectable FVIII inhibitors (Bethesda units, BU), and FVIII activity95% attributable to bypassing agents and factor replacement. Conclusion This real-world analysis highlights the substantial early mortality associated with AHA within 100 days of diagnosis. Severe bleeding and comorbidities were strong predictors of poor outcomes, and management of AHA imposed a considerable pharmacoeconomic burden on tertiary care. Publication History Article published online: 17 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany