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. Our single-center retrospective study aimed to assess clinical features, treatment strategies, and prognostic indicators in adult AHA patients. Eleven patients diagnosed between 2008-2024 were reviewed. Clinical data, laboratory findings, treatments, and outcomes were analyzed. Survival estimates and prognostic factors were evaluated using Kaplan-Meier and univariate analysis. Median age was 41 years; 54.5% 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: 62 days), though 36.4% relapsed. High inhibitor titer (>20 BU) 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 needed to refine management strategies.