Korean J Lab Med.  2008 Feb;28(1):64-69. 10.3343/kjlm.2008.28.1.64.

A Case of Autoimmune Hemolytic Anemia Complicating Hematopoietic Cell Transplantation

• Chae H
• Kim Y
• Kim M
• Lim J
• Han K
• Cho SG
• Lee JW

• KMID: 1781560
• DOI: http://doi.org/10.3343/kjlm.2008.28.1.64

Abstract

A 32-yr-old male diagnosed with myelodysplastic syndrome underwent an unmanipulated, unrelated, HLA matched, peripheral blood stem cell transplantation. The patient and donor were both blood type O, CcDEe. Twelve weeks post-transplantation, he developed acute autoimmune hemolytic anemia (AIHA). He was transfused multiple times with washed O red cells. High-dose steroid therapy was initiated and he underwent splenectomy; however, AIHA was refractory to therapy. The patient was further treated with combined treatment modalities including immunosuppressive therapy with mycophenolate mofetil and cyclosporine and three cycles of plasma exchange, and AIHA responded to treatment. This is the third case of AIHA complicating hematopoietic stem cell transplantation reported in Korea. Since AIHA is relatively common after hematopoietic stem cell transplantation, accurate and timely diagnosis of the disease and treatment strategies with multiple modalities are necessary.

Keyword

Hematopoietic stem cell transplantation (HSCT); Autoimmune hemolytic anemia (AIHA); Immunosuppressive treatment

MeSH Terms

Adult
Anemia, Hemolytic, Autoimmune/*diagnosis/drug therapy/etiology
Combined Modality Therapy
Cyclosporine/therapeutic use
Hematopoietic Stem Cell Transplantation/*adverse effects
Humans
Male
Mycophenolic Acid/analogs & derivatives/therapeutic use
Myelodysplastic Syndromes/complications/diagnosis/therapy
Plasma Exchange

Figure

• 

  Fig. 1. Response of hemoglobin, lactate dehydrogenase, and bilirubin levels to multi-modality therapy.

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