Pathogenesis of cancer-related MAHA remains unknown; three mechanisms might be involved: (i) mechanical lysis of red blood cells, related to tumour micro-emboli in micro-vessels; (ii) inflammatory syndrome following activation of endothelial cells by circulating tumour cells; (iii) activation of the coagulation cascade (high tissue factor expression by endothelial and tumour cells; mucins secretion by tumour cells; von Willebrand Factor release caused by long-lasting bone marrow metastasis) [3–9]. This evidence concerns the gene VWF and neoplasm.