Real-World Clinical Outcomes and Prognostic Factors in Acquired Hemophilia A: A Single-Center Retrospective Analysis

Acquired hemophilia A (AHA) is a rare but potentially life-threatening bleeding disorder. This single-center retrospective study aimed to assess clinical features, treatment strategies, and prognostic indicators in adult AHA patients. Eleven patients diagnosed between 2008 and 2024 were reviewed. Clinical data, laboratory findings, treatments, and outcomes were analyzed. Survival estimates and prognostic factors were evaluated using Kaplan-Meier and univariate analyses. Median age was 41 years; 54.5% of the patients were female. Pregnancy-associated AHA (36.4%) had excellent outcomes with steroid monotherapy and no relapse. Idiopathic and autoimmune cases required combination therapy and had higher relapse rates. The median follow-up duration was 27 months. All patients achieved remission (median response time: 62 days), though 36.4% relapsed. High inhibitor titer (>20 Bethesda unit) predicted delayed response (p=0.038); male sex and major bleeding were linked to shorter relapse-free survival. Baseline inhibitor burden and disease etiology influence AHA prognosis. Tailored therapy and multicenter validation are warranted to refine management strategies.