{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:12:08Z","timestamp":1788444728772,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K23HL159313"],"award-info":[{"award-number":["K23HL159313"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Acquired gastrointestinal vascular malformations not due to congenital disorders such as hereditary hemorrhagic telangiectasia are a common cause of chronic and acute hemorrhage, particularly in older adults. These lesions cause severe anemia, dependence on intravenous iron and\/or red\u2010cell transfusion, and recurring hospitalizations. Hemostatic procedures are temporizing and no standard treatment, including the somatostatin analogs, addresses the underlying angiogenic dysregulation driving vascular malformation formation and recurrence. Therefore, bevacizumab, an anti\u2010VEGF\u2010A monoclonal antibody, is a promising targeted therapeutic. In this observational cohort study, we analyzed 32 patients (median age 75\u2009years, 44% female) with acquired gastrointestinal vascular malformations due to idiopathic angiodysplasia, chronic liver disease, or deficiencies of von Willebrand factor who were treated on a predefined institutional bevacizumab pathway. The median Hematologic Support Score (a composite endpoint integrating red\u2010cell units transfused and elemental iron infused) improved from 15.04 (95% CI, 11.16\u201321.80) red\u2010cell unit equivalents during 6\u2009months pretreatment to 4.08 (4.00\u20138.00) during Months 1\u20136 of bevacizumab treatment (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and further to 0.00 (0.00\u20135.40) during months 7\u201312 (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Units of red cells transfused and quantity of elemental iron infused were analyzed independently; both significantly improved after bevacizumab initiation. Annualized hospitalization\/ED visit rate improved from 3 (year before bevacizumab) to 1 (year after bevacizumab) (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.01), and median hemoglobin improved by 3.1\u2009g\/dL after bevacizumab (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Proteinuria and hypertension occurred in 8 (25%) and 5 (16%) patients, respectively, leading to bevacizumab discontinuation in 3 (9%). In conclusion, bevacizumab is a novel, targeted therapeutic approach for acquired gastrointestinal vascular malformations that may be safe and effective.\n                  <\/jats:p>","DOI":"10.1002\/ajh.70464","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T16:32:29Z","timestamp":1785861149000},"page":"2605-2615","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic Bevacizumab for Severe Bleeding From Acquired Gastrointestinal Vascular Malformations"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1482-7792","authenticated-orcid":false,"given":"Nardeen E.","family":"Ayad","sequence":"first","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology Washington University in St. Louis School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob R.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Medicine Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bimalangshu","family":"Dey","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology Beth Israel Deaconess Medical Center  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9978-8779","authenticated-orcid":false,"given":"Rebecca Karp","family":"Leaf","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Classical Hematology Mass General Brigham Cancer Institute, Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6915-8733","authenticated-orcid":false,"given":"Andrew B.","family":"Song","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Classical Hematology Mass General Brigham Cancer Institute, Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6175-1383","authenticated-orcid":false,"given":"Hanny","family":"Al\u2010Samkari","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Classical Hematology Mass General Brigham Cancer Institute, Massachusetts General Hospital  Boston Massachusetts 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