Autoimmune hemolytic anemia associated with B-cell chronic lymphoproliferative disorders.
10.7534/j.issn.1009-2137.2013.03.019
- Author:
Yun ZHUANG
1
;
Lei FAN
;
Yun-Feng SHEN
;
Wei XU
;
Jian-Yong LI
Author Information
1. Department of Hematology, Wuxi People Hospital Affiliated of Nanjing Medical University, Wuxi, Jiangsu Province, China.
- Publication Type:Journal Article
- MeSH:
Adrenal Cortex Hormones;
therapeutic use;
Adult;
Aged;
Anemia, Hemolytic, Autoimmune;
complications;
diagnosis;
therapy;
Antibodies, Monoclonal, Murine-Derived;
therapeutic use;
Female;
Humans;
Leukemia, Lymphocytic, Chronic, B-Cell;
complications;
diagnosis;
therapy;
Male;
Middle Aged;
Retrospective Studies;
Rituximab;
Young Adult
- From:
Journal of Experimental Hematology
2013;21(3):633-636
- CountryChina
- Language:Chinese
-
Abstract:
This study was purpose to investigate the clinical characteristics of B-cell chronic lymphoproliferative disorders (B-CLPD) complicated by autoimmune hemolytic anemia (AIHA) so as to improve the understanding of this disease. The clinical characteristics, laboratory data, therapy and outcome of 14 patients suffering from B-CLPD complicated by AIHA were retrospectively analyzed in Wuxi People Hospital and the First Affiliated Hospital of Nanjing Medical University from 2000 to 2012. The results showed that 9 cases of the 14 patients were patients with chronic lymphocytic leukemia (CLL), 5 cases were patients with lymphoma, at time of hemolysis the median level of hemoglobin was 61 (33 - 84)g/L, the median ratio of reticulocytes was 12.0 (3.1 - 35.0)%, the positive rate of Coombs test was 100%. 1 case received corticosteroid alone, 5 cases were treated with chemotherapy combined with corticosteroid, 8 cases were treated with immunochemotherapy rituximab combined with corticosteroid. Overall response rate was 100%, in which CR was 78.6% (11/14), PR was 21.4% (3/14). The follow-up for these patients were performed to now, 35.7% (5/14) patients relapsed with hemolysis again, but they showed therapeutic response to treatment with above-mentioned therapy. From patients treated with rituximab alone, only 1 patient relapsed. Among 14 patients, 6 cases died, 1 case was lost, the other cases are still alive. It is concluded that the AIHA is the commonest complication of B-CLPD, it can be observed at different stages of B-CLPD, the treatment with corticosteroids can give well therapeutic effect for these patients, but the long time CR is lower, the rituximab has been confirmed to be effective for B-CLPD complicated by AIHA.