Abstract
Bleeding and thrombosis are important complications in patients with malignant lymphomas.
They may be due to direct actions of the lymphoma, such as venous compression or bone
marrow infiltration, but they may also be caused by paraneoplastic phenomena, which
are immune-mediated in most of the cases. The most important paraneoplastic immune-mediated
disorders in lymphomas causing bleeding are autoimmune thrombocytopenia, acquired
hemophilia A and acquired von Willebrand syndrome. In addition, there are a variety
of other less common immune-mediated bleeding conditions, such as acquired thrombasthenia,
acquired factor X-, V-, XI-, XII-, or prothrombin deficiency. The presence of antiphospholipid
antibodies is a rare condition predisposing to venous and arterial thrombosis and
there are other very uncommon conditions, which predispose exclusively to arterial
thrombosis such as hyperlipidemic xanthomatosis. Interestingly, there is hardly any
correlation between the histological type and the aggressiveness of lymphoma and the
type and prevalence of the immune-mediated conditions. Successful treatment of the
underlying lymphoma is often associated with definite and sustained resolution of
the immune-mediated disorder.
Keywords
lymphoma - autoimmune complications - thrombosis - bleeding - treatment
