Mixed-type autoimmune hemolytic anemia following fludarabine treatment in a patient with chronic lymphocytic leukemia/small cell lymphoma.

Autor: Vick DJ; Department of Pathology, Walter Reed Army Medical Center, Washington, DC 20307, USA. djvick615@POL.NET, Byrd JC, Beal CL, Chaffin DJ
Jazyk: angličtina
Zdroj: Vox sanguinis [Vox Sang] 1998; Vol. 74 (2), pp. 122-6.
Abstrakt: Background and Objectives: Mixed-type autoimmune hemolytic anemia (AIHA) is a rare complication of chronic lymphocytic leukemia (CLL). We report a patient with small lymphocytic lymphoma (phenotypic CLL) who developed symptomatic anemia 3 weeks after her fifth cycle of fludarabine, a T cell immunosuppressant.
Materials and Methods: An antibody screen and panel, direct antiglobulin test, rapid acid eluate, rabbit erythrocyte stroma (RESt) adsorption, and autoadsorption were performed.
Results: Warm and cold autoantibodies were detected. prompt treatment with corticosteroids and minimal blood transfusions led to marked improvement.
Conclusion: Normally, T cells suppress polyclonal lymphocytes that produce autoantibodies. Suppression of T cells in this patient, in addition to the underlying disease process, may explain this mixed-type AIHA, the first reported case to occur following fludarabine treatment.
Databáze: MEDLINE
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