Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2019 Nov;8(15):6549-6558.
doi: 10.1002/cam4.2539. Epub 2019 Sep 10.

Autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation in adults: A southern China multicenter experience

Weiran Lv  1 , Hong Qu  1   2 , Meiqing Wu  3 , Zhiping Fan  1 , Fen Huang  1 , Na Xu  1 , Li Xuan  1 , Ren Lin  1 , Ke Zhao  1 , Jing Sun  1 , Yongrong Lai  3 , Yajing Xu  4 , Qifa Liu  1
Affiliations
Multicenter Study

Autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation in adults: A southern China multicenter experience

Weiran Lv et al. Cancer Med. 2019 Nov.

Abstract

To investigate the incidence and risk factors as well as prognosis of autoimmune hemolytic anemia (AIHA) following allogeneic hematopoietic stem cell transplantation (allo-HSCT), a total of 1377 adult hematological malignancies at three institutions were enrolled in this study. The 3-year cumulative incidence of AIHA was 2.2 ± 0.4%. Multivariate analysis showed that haploidentical donors (HRDs) and chronic graft vs host disease (cGVHD) were the independent risk factors for AIHA. Patients with AIHA treated initially with corticosteroids combined with cyclosporine A (CsA) had a higher complete response rate than those with corticosteroids monotherapy (66.7% vs 11.1%; P = .013). The 3-year cumulative incidence of malignant diseases relapse was 4.4 ± 4.3% and 28.0 ± 1.3% (P = .013), treatment-related mortality (TRM) was 8.9 ± 6.3% and 17.4 ± 1.2% (P = .431), disease-free survival (DFS) was 56.1 ± 1.5% and 86.7 ± 7.2% (P = .011), and overall survival (OS) was 86.3 ± 7.4% and 64.1 ± 1.5% (P = .054), respectively, in the patients with AIHA and those without AIHA. Our results indicate that HRDs and cGVHD are risk factors for AIHA and corticosteroids combined with CsA are superior to corticosteroids as initial treatment for AIHA. Autoimmune hemolytic anemia does not contribute to increase TRM and could reduce the malignant diseases relapse and increase DFS.

Keywords: autoimmune hemolytic anemia; hematopoietic stem cell transplantation; risk factors; treatment.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Cumulative incidence of autoimmune hemolytic anemia (AIHA) according to type of donor
Figure 2
Figure 2
Relapse, treatment‐related mortality, disease‐free survival, and overall survival in patients with and without autoimmune hematological diseases (AIHA). A, Accumulation underlying malignancy relapse rate in patients with and without AIHA. B, Accumulation of treatment‐related mortality in patients with and without AIHA. C, Accumulation of disease‐free survival function in patients with and without AIHA. D, Accumulation of survival function in patients with and without AIHA
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Chang YJ, Zhao XY, Xu LP, et al. Donor‐specific anti‐human leukocyte antigen antibodies were associated with primary graft failure after unmanipulated haploidentical blood and marrow transplantation: a prospective study with randomly assigned training and validation sets. J Hematol Oncol. 2015;8:84. - PMC - PubMed
    1. Drobyski WR, Potluri J, Sauer D, et al. Autoimmune hemolytic anemia following T cell‐depleted allogeneic bone marrow transplantation. Bone Marrow Transplant. 1996;17:1093‐1099. - PubMed
    1. O'Brien TA, Eastlund T, Peters C, et al. Autoimmune haemolytic anaemia complicating haematopoietic cell transplantation in paediatric patients: high incidence and significant mortality in unrelated donor transplants for non‐malignant diseases. Br J Haematol. 2004;127:67‐75. - PubMed
    1. Daikeler T, Tyndall A. Autoimmunity following haematopoietic stem cell transplantation. Best Pract Res Clin Haematol. 2007;20:349‐360. - PubMed
    1. Loh Y, Oyama Y, Statkute L, et al. Development of a secondary autoimmune disorder after hematopoietic stem cell transplantation for autoimmune diseases: role of conditioning regimen used. Blood. 2007;109:2643‐2648. - PubMed

Publication types

MeSH terms