{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T15:09:10Z","timestamp":1780412950712,"version":"3.54.1"},"reference-count":17,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,5,6]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>Inherited fibrinogen disorders (IFDs) are rare, and limited evidence-based management guidelines exist, especially regarding haematological malignancies and haematopoietic stem cell transplantion (HSCT). This case highlights the successful multidisciplinary management of an adult patient with acute Philadelphia-negative B-cell lymphoblastic leukaemia (B-ALL) and IFD from induction through HSCT. A patient in his 20s with an IFD is diagnosed with B-ALL and receives induction chemotherapy, including dose-reduced pegaspargase (PEG-Asp), blinatumomab consolidative therapy and HSCT for post-induction measurable residual disease (MRD) positivity. Management involved prophylactic anticoagulation (AC) during induction and pharmacokinetic-guided fibrinogen replacement. Complications were iatrogenic intracranial hypotension and acute catheter-associated proximal deep vein thrombosis managed with therapeutic AC. One year post-HSCT, he remained MRD-negative with 100% donor chimerism. This case highlights a management strategy for patients with IFD requiring chemotherapy and\/or HSCT and addresses a critical gap in knowledge.<\/jats:p>","DOI":"10.1136\/bcr-2025-268637","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T14:20:36Z","timestamp":1780410036000},"page":"e268637","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Management of inherited fibrinogen disorder during chemotherapy and allogeneic stem cell transplant"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2422-6047","authenticated-orcid":false,"given":"Yiseiry","family":"Perez-Melendez","sequence":"first","affiliation":[{"name":"Medicine, Medical University of South Carolina, Charleston, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0827-0887","authenticated-orcid":false,"given":"Tharakeswari","family":"Selvakumar","sequence":"additional","affiliation":[{"name":"Medicine, Medical University of South Carolina, Charleston, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Medicine, Medical University of South Carolina, Charleston, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shayla","family":"Bergman","sequence":"additional","affiliation":[{"name":"Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Coltoff","sequence":"additional","affiliation":[{"name":"Medicine, Medical University of South Carolina, Charleston, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3188-4465","authenticated-orcid":false,"given":"Kimberley","family":"Youkhana","sequence":"additional","affiliation":[{"name":"Medicine, Medical University of South Carolina, Charleston, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"2026060207001088000_19.6.e268637.1","unstructured":"Hemophilia WFo . 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