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Biol Blood Marrow Transplant. 2015 Jan;21(1):60-6. doi: 10.1016/j.bbmt.2014.09.009. Epub 2014 Sep 28.

Autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation: analysis of 533 adult patients who underwent transplantation at King's College Hospital.

Author information

1
Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, and King's College London, London, United Kingdom. Electronic address: mengwang@nhs.net.
2
School of Computing Sciences, University of East Anglia, Norwich, United Kingdom.
3
Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, and King's College London, London, United Kingdom.

Abstract

Autoimmune hemolytic anemia (AIHA) is a recognized complication of hematopoietic stem cell transplantation (HSCT); it is often refractory to treatment and carries a high mortality. To improve understanding of the incidence, risk factors, and clinical outcome of post-transplantation AIHA, we analyzed 533 patients who received allogeneic HSCT, and we identified 19 cases of AIHA after HSCT (overall incidence, 3.6%). The median time to onset, from HSCT to AIHA, was 202 days. AIHA was associated with HSCT from unrelated donors (hazard ratio [HR], 5.28; 95% confidence interval [CI], 1.22 to 22.9; P = .026). In the majority (14 of 19; 74%) of AIHA patients, multiple agents for treatment were required, with only 9 of 19 (47%) patients achieving complete resolution of AIHA. Patients with post-transplantation AIHA had a higher overall mortality (HR, 2.48; 95% CI, 1.33 to 4.63; P = .004), with 36% (4 of 11 cases) of deaths attributable to AIHA.

KEYWORDS:

Allogeneic hematopoietic stem cell transplantation; Autoimmune hemolytic anemia; Mortality

PMID:
25262883
DOI:
10.1016/j.bbmt.2014.09.009
[Indexed for MEDLINE]
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