Skip to main content

Advertisement

SpringerLink
Log in

Current Approaches for the Treatment of Autoimmune Hemolytic Anemia

  • Review
  • Published:
Archivum Immunologiae et Therapiae Experimentalis Aims and scope

Abstract

Autoimmune hemolytic anemia (AIHA) is an infrequent group of diseases defined by autoantibody mediated red blood cell destruction. Correct diagnosis and classification of this condition are essential to provide appropriate treatment. AIHA is divided into warm and cold types according to the characteristics of the autoantibody involved and by the presence of an underlying or associated disorder into primary and secondary AIHA. Due to its low frequency, treatment for AIHA is largely based on small prospective trials, case series, and empirical observations. This review describes in detail the different treatment approaches for autoimmune hemolytic anemia. Warm antibody type AIHA should be treated with steroids, to which most patients respond, although relapse can occur and maintenance doses are frequently required. Splenectomy is an effective second line treatment and can provide long-term remission without medication. Rituximab is a useful alternative for steroid refractory patients, those requiring high maintenance doses and unfavorable candidates for surgery. Promising therapeutic modifications with this monoclonal antibody are emerging including drug combinations, lower doses, and long-term use. Primary cold agglutinin disease has been recognized as having a lymphoproliferative monoclonal origin. It is unresponsive to both steroids and splenectomy. Rituximab is currently the best therapeutic alternative for this condition, and several treatment regimens are available with variable responses.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Ahn YS (1990) Efficacy of danazol in hematologic disorders. Acta Haematol 84:122–129

    Article  PubMed  CAS  Google Scholar 

  • Akpek G, McAneny D, Weintraub L (1999) Comparative response to splenectomy in Coombs-positive autoimmune hemolytic anemia with or without associated disease. Am J Hematol 61:98–102

    Article  PubMed  CAS  Google Scholar 

  • Alba P, Karim MY, Hunt BJ (2003) Mycophenolate mofetil as a treatment for autoimmune haemolytic anaemia in patients with systemic lupus erythematosus and antiphospholipid syndrome. Lupus 12:633–635

    Article  PubMed  CAS  Google Scholar 

  • Allgood JW, Chaplin H Jr (1967) Idiopathic acquired autoimmune hemolytic anemia. A review of forty-seven cases treated from 1955 through 1965. Am J Med 43:254–273

    Article  PubMed  CAS  Google Scholar 

  • Arndt PA, Garratty G (2005) The changing spectrum of drug-induced immune hemolytic anemia. Semin Hematol 42:137–144

    Article  PubMed  CAS  Google Scholar 

  • Barcellini W, Zaja F, Zaninoni A et al (2012) Low-dose rituximab in adult patients with idiopathic autoimmune hemolytic anemia: clinical efficacy and biologic studies. Blood 119:3691–3697

    Article  PubMed  CAS  Google Scholar 

  • Barros MM, Blajchman MA, Bordin JO (2010) Warm autoimmune hemolytic anemia: recent progress in understanding the immunobiology and the treatment. Transfus Med Rev 24:195–210

    Article  PubMed  Google Scholar 

  • Bell CA, Zwicker H, Sacks HJ (1973) Autoimmune hemolytic anemia: routine serologic evaluation in a general hospital population. Am J Clin Pathol 60:903–911

    PubMed  CAS  Google Scholar 

  • Berentsen S, Tjonnfjord G (2012) Diagnosis and treatment of cold agglutinin mediated autoimmune hemolytic anemia. Blood Rev 26:107–115

    Article  PubMed  CAS  Google Scholar 

  • Berentsen S, Ulvestad E, Gjertsen BT et al (2004) Rituximab for primary chronic cold agglutinin disease: a prospective study of 37 courses of therapy in 27 patients. Blood 103:2925–2928

    Article  PubMed  CAS  Google Scholar 

  • Berentsen S, Ulvestad E, Langholm R et al (2006) Primary chronic cold agglutinin disease: a population based clinical study of 86 patients. Haematologica 91:460–466

    PubMed  Google Scholar 

  • Berentsen S, Randen U, Vagan AM et al (2010) High response rate and durable remissions following fludarabine and rituximab combination therapy for chronic cold agglutinin disease. Blood 116:3180–3184

    Article  PubMed  CAS  Google Scholar 

  • Bottiger LE, Westerholm B (1973) Acquired haemolytic anaemia. I. Incidence and aetiology. Acta Med Scand 193:223–226

    Article  PubMed  CAS  Google Scholar 

  • Bowen DA, Call TG, Shanafelt TD et al (2010) Treatment of autoimmune cytopenia complicating progressive chronic lymphocytic leukemia/small lymphocytic lymphoma with rituximab, cyclophosphamide, vincristine and prednisone. Leuk Lymphoma 51:620–627

    Article  PubMed  CAS  Google Scholar 

  • Branch DR, Petz LD (1999) Detecting alloantibodies in patients with autoantobodies. Transfusion 39:6–10

    Article  PubMed  CAS  Google Scholar 

  • Brigden ML (1992) Overwhelming postsplenectomy infection still a problem. West J Med 157:440–443

    PubMed  CAS  Google Scholar 

  • Buetens OW, Ness PM (2003) Red blood cell transfusion in autoimmune hemolytic anemia. Curr Opin Hematol 10:429–433

    Article  PubMed  Google Scholar 

  • Bussone G, Ribeiro E, Dechartres A et al (2009) Efficacy and safety of rituximab in adults’ warm antibody autoimmune haemolytic anemia: retrospective analysis of 27 cases. Am J Hematol 84:153–157

    Article  PubMed  CAS  Google Scholar 

  • Carson KR, Evens AM, Richey EA et al (2009) Progressive multifocal leukoencephalopathy after rituximab therapy in HIV-negative patients: a report of 57 cases from the research on adverse drug events and reports project. Blood 113:4834–4840

    Article  PubMed  CAS  Google Scholar 

  • Carson KR, Beckwith LG, Mehta J (2010) Successful treatment of IgM-mediated autoimmune hemolytic anemia with bortezomib. Blood 115:915

    Article  PubMed  CAS  Google Scholar 

  • Casaccia M, Torelli P, Squarcia S et al (2006) Laparoscopic splenectomy for hematologic diseases: a preliminary analysis performed on the Italian Registry of Laparoscopic Surgery of the Spleen (IRLSS). Surg Endosc 20:1214–1220

    Article  PubMed  CAS  Google Scholar 

  • Cherry JD (1993) Anemia and mucocutaneous lesions due to Mycoplasma pneumoniae infections. Clin Infect Dis 17(1 Suppl):S47–S51

    Article  PubMed  Google Scholar 

  • Chertkow G, Dacie JV (1956) Results of splenectomy in auto-immune haemolytic anaemia. Br J Haematol 2:237–249

    Article  PubMed  CAS  Google Scholar 

  • Cheung WW, Hwang GY, Tse E et al (2006) Alemtuzumab induced complete remission of autoimmune hemolytic anemia refractory to corticosteroids, splenectomy and rituximab. Haematologica 91(5 Suppl):13

    Google Scholar 

  • Chu CS, Braun SR, Yarbro JW et al (1990) Corticosteroid treatment for hemolytic anemia associated with Mycoplasma pneumoniae pneumonia. South Med J 83:1106–1108

    Article  PubMed  CAS  Google Scholar 

  • Condliffe R, Kiely DG, Gibbs JS et al (2009) Prognostic and aetiological factors in chronic thromboembolic pulmonary hypertension. Eur Respir J 33:332–338

    Article  PubMed  CAS  Google Scholar 

  • Confavreux C, Seve P, Broussolle C et al (2003) Danazol-induced hepatocellular carcinoma. QJM 96:317–318

    Article  PubMed  CAS  Google Scholar 

  • Coon WW (1985) Splenectomy in the treatment of hemolytic anemia. Arch Surg 120:625–628

    Article  PubMed  CAS  Google Scholar 

  • Dacie JV (1975) Autoimmune hemolytic anemia. Arch Intern Med 135:1293–1300

    Article  PubMed  CAS  Google Scholar 

  • Danchaivijitr P, Yared J, Rapoport AP (2011) Successful treatment of IgG and complement-mediated autoimmune hemolytic anemia with bortezomib and low-dose cyclophosphamide. Am J Hematol 86:331–332

    Article  PubMed  Google Scholar 

  • Darabi K, Abdel-Wahab O, Dzik WH (2006) Current usage of intravenous immune globulin and the rationale behind it: the Massachusetts General Hospital data and a review of the literature. Transfusion 46:741–753

    Article  PubMed  CAS  Google Scholar 

  • D’Arena G, Laurenti L, Capalbo S et al (2006) Rituximab therapy for chronic lymphocytic leukemia-associated autoimmune hemolytic anemia. Am J Hematol 81:598–602

    Article  PubMed  CAS  Google Scholar 

  • D’Arena G, Califano C, Annunziata M et al (2007) Rituximab for warm-type idiopathic autoimmune hemolytic anemia: a retrospective study of 11 adult patients. Eur J Haematol 79:53–58

    Article  PubMed  CAS  Google Scholar 

  • Dausset J, Colombani J (1959) The serology and the prognosis of 128 cases of autoimmune hemolytic anemia. Blood 14:1280–1301

    PubMed  CAS  Google Scholar 

  • Davidson RN, Wall RA (2001) Prevention and management of infections in patients without a spleen. Clin Microbiol Infect 7:657–660

    Article  PubMed  CAS  Google Scholar 

  • Davies JM, Lewis MP, Wimperis J et al (2011) Review of guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen: prepared on behalf of the British Committee for Standards in Haematology by a working party of the Haemato-Oncology task force. Br J Haematol 155:308–317

    Article  PubMed  CAS  Google Scholar 

  • Evans RS, Weiser RS (1957) The serology of autoimmune hemolytic disease; observations on forty-one patients. AMA Arch Intern Med 100:371–399

    Article  PubMed  CAS  Google Scholar 

  • Fagiolo E (2004) Immunological tolerance loss vs. erythrocyte self antigens and cytokine network disregulation in autoimmune hemolytic anaemia. Autoimmun Rev 3:53–59

    Article  PubMed  CAS  Google Scholar 

  • Flores G, Cunningham-Rundles C, Newland AC et al (1993) Efficacy of intravenous immunoglobulin in the treatment of autoimmune hemolytic anemia: results in 73 patients. Am J Hematol 44:237–242

    Article  PubMed  CAS  Google Scholar 

  • Fozza C, Longinotti M (2011) Use of rituximab in autoimmune hemolytic anemia associated with non-Hodgkin lymphomas. Adv Hematol 2011:960137

    PubMed  Google Scholar 

  • Garratty G (2010) Immune hemolytic anemia associated with drug therapy. Blood Rev 24:143–150

    Article  PubMed  CAS  Google Scholar 

  • Garvey B (2008) Rituximab in the treatment of autoimmune haematological disorders. Br J Haematol 141:149–169

    Article  PubMed  CAS  Google Scholar 

  • Gehrs BC, Friedberg RC (2002) Autoimmune hemolytic anemia. Am J Hematol 69:258–271

    Article  PubMed  Google Scholar 

  • Geurs F, Ritter K, Mast A et al (1992) Successful plasmapheresis in corticosteroid-resistant hemolysis in infectious mononucleosis: role of autoantibodies against triosephosphate isomerase. Acta Haematol 88:142–146

    Article  PubMed  CAS  Google Scholar 

  • Gomard-Mennesson E, Ruivard M, Koenig M et al (2006) Treatment of isolated severe immune hemolytic anaemia associated with systemic lupus erythematosus: 26 cases. Lupus 15:223–231

    Article  PubMed  CAS  Google Scholar 

  • Gomez-Almaguer D, Solano-Genesta M, Tarin-Arzaga L et al (2010) Low-dose rituximab and alemtuzumab combination therapy for patients with steroid-refractory autoimmune cytopenias. Blood 116:4783–4785

    Article  PubMed  CAS  Google Scholar 

  • Gopal V, Bisno AL (1977) Fulminant pneumococcal infections in ‘normal’ asplenic hosts. Arch Intern Med 137:1526–1530

    Article  PubMed  CAS  Google Scholar 

  • Grant IR, Parsons SW, Johnstone JM et al (1988) Elective splenectomy in haematological disorders. Ann R Coll Surg Engl 70:29–33

    PubMed  CAS  Google Scholar 

  • Gupta N, Kavuru S, Patel D et al (2002) Rituximab-based chemotherapy for steroid-refractory autoimmune hemolytic anemia of chronic lymphocytic leukemia. Leukemia 16:2092–2095

    Article  PubMed  CAS  Google Scholar 

  • Hauswirth AW, Skrabs C, Schutzinger C et al (2007) Autoimmune hemolytic anemias, Evans’ syndromes, and pure red cell aplasia in non-Hodgkin lymphomas. Leuk Lymphoma 48:1139–1149

    Article  PubMed  Google Scholar 

  • Hendrick AM (2003) Auto-immune haemolytic anaemia–a high-risk disorder for thromboembolism? Hematology 8:53–56

    Article  PubMed  CAS  Google Scholar 

  • Hershko C, Sonnenblick M, Ashkenazi J (1990) Control of steroid-resistant autoimmune haemolytic anaemia by cyclosporine. Br J Haematol 76:436–437

    Article  PubMed  CAS  Google Scholar 

  • Hillen HF, Bakker SJ (1994) Failure of interferon-alpha-2b therapy in chronic cold agglutinin disease. Eur J Haematol 53:242–243

    Article  PubMed  CAS  Google Scholar 

  • Hodgson K, Ferrer G, Pereira A et al (2011) Autoimmune cytopenia in chronic lymphocytic leukaemia: diagnosis and treatment. Br J Haematol 154:14–22

    Article  PubMed  Google Scholar 

  • Hoffman PC (2006) Immune hemolytic anemia–selected topics. Hematology Am Soc Hematol Educ Program 2006:13–18

    Article  Google Scholar 

  • Hoffman PC (2009) Immune hemolytic anemia–selected topics. Hematology Am Soc Hematol Educ Program 2009:80–86

    Article  Google Scholar 

  • Howard J, Hoffbrand AV, Prentice HG et al (2002) Mycophenolate mofetil for the treatment of refractory auto-immune haemolytic anaemia and auto-immune thrombocytopenia purpura. Br J Haematol 117:712–715

    Article  PubMed  CAS  Google Scholar 

  • Kamesaki T, Toyotsuji T, Kajii E (2013) Characterization of direct antiglobulin test-negative autoimmune hemolytic anemia: a study of 154 cases. Am J Hematol 88:93–96

    Article  PubMed  CAS  Google Scholar 

  • Kaufman M, Limaye SA, Driscoll N et al (2009) A combination of rituximab, cyclophosphamide and dexamethasone effectively treats immune cytopenias of chronic lymphocytic leukemia. Leuk Lymphoma 50:892–899

    Article  PubMed  CAS  Google Scholar 

  • King KE, Ness PM (2005) Treatment of autoimmune hemolytic anemia. Semin Hematol 42:131–136

    Article  PubMed  CAS  Google Scholar 

  • Klein NP, Ray P, Carpenter D et al (2010) Rates of autoimmune diseases in Kaiser Permanente for use in vaccine adverse event safety studies. Vaccine 28:1062–1068

    Article  PubMed  Google Scholar 

  • Kokori SI, Ioannidis JP, Voulgarelis M et al (2000) Autoimmune hemolytic anemia in patients with systemic lupus erythematosus. Am J Med 108:198–204

    Article  PubMed  CAS  Google Scholar 

  • Krauth MT, Lechner K, Neugebauer EA et al (2008) The postoperative splenic/portal vein thrombosis after splenectomy and its prevention–an unresolved issue. Haematologica 93:1227–1232

    Article  PubMed  Google Scholar 

  • Lechner K, Jager U (2010) How I treat autoimmune hemolytic anemias in adults. Blood 116:1831–1838

    Article  PubMed  CAS  Google Scholar 

  • Liesveld JL, Rowe JM, Lichtman MA (1987) Variability of the erythropoietic response in autoimmune hemolytic anemia: analysis of 109 cases. Blood 69:820–826

    PubMed  CAS  Google Scholar 

  • Logue G, Rosse W (1976) Immunologic mechanisms in autoimmune hemolytic disease. Semin Hematol 13:277–289

    PubMed  CAS  Google Scholar 

  • McLeod BC (2007) Evidence based therapeutic apheresis in autoimmune and other hemolytic anemias. Curr Opin Hematol 14:647–654

    Article  PubMed  CAS  Google Scholar 

  • Moyo VM, Smith D, Brodsky I et al (2002) High-dose cyclophosphamide for refractory autoimmune hemolytic anemia. Blood 100:704–706

    Article  PubMed  CAS  Google Scholar 

  • Mqadmi A, Zheng X, Yazdanbakhsh K (2005) CD4 + CD25 + regulatory T cells control induction of autoimmune hemolytic anemia. Blood 105:3746–3748

    Article  PubMed  CAS  Google Scholar 

  • Murphy S, LoBuglio AF (1976) Drug therapy of autoimmune hemolytic anemia. Semin Hematol 13:323–334

    PubMed  CAS  Google Scholar 

  • Nanan R, Scheurlen W, Gerlich M et al (1995) Severe low-titer cold-hemagglutinin disease responsive to steroid pulse therapy. Ann Hematol 71:101–102

    Article  PubMed  CAS  Google Scholar 

  • Narat S, Gandla J, Hoffbrand AV et al (2005) Rituximab in the treatment of refractory autoimmune cytopenias in adults. Haematologica 90:1273–1274

    PubMed  CAS  Google Scholar 

  • Nydegger UE, Kazatchkine MD, Miescher PA (1991) Immunopathologic and clinical features of hemolytic anemia due to cold agglutinins. Semin Hematol 28:66–77

    PubMed  CAS  Google Scholar 

  • Osterborg A, Karlsson C, Lundin J (2009) Alemtuzumab to treat refractory autoimmune hemolytic anemia or thrombocytopenia in chronic lymphocytic leukemia. Curr Hematol Malig Rep 4:47–53

    Article  PubMed  Google Scholar 

  • Packman CH (2008) Hemolytic anemia due to warm autoantibodies. Blood Rev 22:17–31

    Article  PubMed  CAS  Google Scholar 

  • Passweg JR, Rabusin M, Musso M et al (2004) Haematopoetic stem cell transplantation for refractory autoimmune cytopenia. Br J Haematol 125:749–755

    Article  PubMed  CAS  Google Scholar 

  • Penalver FJ, Alvarez-Larran A, Diez-Martin JL et al (2010) Rituximab is an effective and safe therapeutic alternative in adults with refractory and severe autoimmune hemolytic anemia. Ann Hematol 89:1073–1080

    Article  PubMed  CAS  Google Scholar 

  • Pepke-Zaba J, Delcroix M, Lang I et al (2011) Chronic thromboembolic pulmonary hypertension (CTEPH): results from an international prospective registry. Circulation 124:1973–1981

    Article  PubMed  Google Scholar 

  • Petz LD (2001) Treatment of autoimmune hemolytic anemias. Curr Opin Hematol 8:411–416

    Article  PubMed  CAS  Google Scholar 

  • Petz LD (2004) A physician’s guide to transfusion in autoimmune haemolytic anaemia. Br J Haematol 124:712–716

    Article  PubMed  Google Scholar 

  • Petz LD (2008) Cold antibody autoimmune hemolytic anemias. Blood Rev 22:1–15

    Article  PubMed  Google Scholar 

  • Petz LD, Garratty G (2004a) Immune hemolytic anemias, 2nd edn. Churchill Livingstone/Elsevier Science, Philadelphia

    Google Scholar 

  • Petz LD, Garraty G (2004b) Blood transfusion in autoimmune hemolytic anemias. In: Immune Hemolyytic Anemias, 2nd edn. Churchill Livingstone, New York, pp 375–400

  • Pignon JM, Poirson E, Rochant H (1993) Danazol in autoimmune haemolytic anaemia. Br J Haematol 83:343–345

    Article  PubMed  CAS  Google Scholar 

  • Pullarkat V, Ngo M, Iqbal S et al (2002) Detection of lupus anticoagulant identifies patients with autoimmune haemolytic anaemia at increased risk for venous thromboembolism. Br J Haematol 118:1166–1169

    Article  PubMed  Google Scholar 

  • Puthenparambil J, Lechner K, Kornek G (2010) Autoimmune hemolytic anemia as a paraneoplastic phenomenon in solid tumors: a critical analysis of 52 cases reported in the literature. Wien Klin Wochenschr 122:229–236

    Article  PubMed  CAS  Google Scholar 

  • Quartier P, Brethon B, Philippet P et al (2001) Treatment of childhood autoimmune haemolytic anaemia with rituximab. Lancet 358:1511–1513

    Article  PubMed  CAS  Google Scholar 

  • Ram S, Lewis LA, Rice PA (2010) Infections of people with complement deficiencies and patients who have undergone splenectomy. Clin Microbiol Rev 23:740–780

    Article  PubMed  CAS  Google Scholar 

  • Rao VK, Dugan F, Dale JK et al (2005) Use of mycophenolate mofetil for chronic, refractory immune cytopenias in children with autoimmune lymphoproliferative syndrome. Br J Haematol 129:534–538

    Article  PubMed  CAS  Google Scholar 

  • Rivero SJ, Alger M, Alarcón-Segovia D (1979) Splenectomy for hemocytopenia in systemic lupus erythematosus. A controlled appraisal. Arch Intern Med 139:773–776

    Article  PubMed  CAS  Google Scholar 

  • Robak T (2004) Monoclonal antibodies in the treatment of autoimmune cytopenias. Eur J Haematol 72:79–88

    Article  PubMed  CAS  Google Scholar 

  • Rordorf R, Barth A, Nydegger U et al (1994) Treatment of severe idiopathic cold-agglutinin diseases using interferon-alpha 2b. Schweiz Med Wochenschr 124:56–61

    PubMed  CAS  Google Scholar 

  • Rossignol J, Michallet A-S, Oberic L et al (2011) Rituximab-cyclophosphamide-dexamethasone combination in the management of autoimmune cytopenias associated with chronic lymphocytic leukemia. Leukemia 25:473–478

    Article  PubMed  CAS  Google Scholar 

  • Roth A, Huttmann A, Rother RP et al (2009) Long-term efficacy of the complement inhibitor eculizumab in cold agglutinin disease. Blood 113:3885–3886

    Article  PubMed  Google Scholar 

  • Ruivard M, Tournilhac O, Montel S et al (2006) Plasma exchanges do not increase red blood cell transfusion efficiency in severe autoimmune hemolytic anemia: a retrospective case-control study. J Clin Apher 21:202–206

    Article  PubMed  Google Scholar 

  • Schollkopf C, Kjeldsen L, Bjerrum OW et al (2006) Rituximab in chronic cold agglutinin disease: a prospective study of 20 patients. Leuk Lymphoma 47:253–260

    Article  PubMed  CAS  Google Scholar 

  • Schreiber AD, Herskovitz BS, Goldwein M (1977) Low-titer cold-hemagglutinin disease. Mechanism of hemolysis and response to corticosteroids. N Engl J Med 296:1490–1494

    Article  PubMed  CAS  Google Scholar 

  • Schrezenmeier H, Hochsmann B (2012) Drugs that inhibit complement. Transfus Apher Sci 46:87–92

    Article  PubMed  Google Scholar 

  • Schubothe H (1966) The cold hemagglutinin disease. Semin Hematol 3:27–47

    PubMed  CAS  Google Scholar 

  • Semple JW, Freedman J (2005) Autoimmune pathogenesis and autoimmune hemolytic anemia. Semin Hematol 42:122–130

    Article  PubMed  CAS  Google Scholar 

  • Shanafelt TD, Madueme HL, Wolf RC et al (2003) Rituximab for immune cytopenia in adults: idiopathic thrombocytopenic purpura, autoimmune hemolytic anemia, and Evans syndrome. Mayo Clin Proc 78:1340–1346

    Article  PubMed  CAS  Google Scholar 

  • Sokol RJ, Hewitt S, Stamps BK (1981) Autoimmune haemolysis: an 18-year study of 865 cases referred to a regional transfusion centre. Br Med J 282:2023–2027

    Article  CAS  Google Scholar 

  • Taft EG, Propp RP, Sullivan SA (1977) Plasma exchange for cold agglutinin hemolytic anemia. Transfusion 17:173–176

    Article  PubMed  CAS  Google Scholar 

  • Thieblemont C, Felman P, Callet-Bauchu E et al (2003) Splenic marginal-zone lymphoma: a distinct clinical and pathological entity. Lancet Oncol 4:95–103

    Article  PubMed  CAS  Google Scholar 

  • Tisdale WA, Klatskin G, Kinsella ED (1959) The significance of the direct-reacting fraction of serum bilirubin in hemolytic jaundice. Am J Med 26:214–227

    Article  PubMed  CAS  Google Scholar 

  • Trape G, Fianchi L, Lai M et al (2003) Rituximab chimeric anti-CD20 monoclonal antibody treatment for refractory hemolytic anemia in patients with lymphoproliferative disorders. Haematologica 88:223–225

    PubMed  CAS  Google Scholar 

  • Tsuruta R, Kawamura Y, Inoue T et al (2002) Corticosteroid therapy for hemolytic anemia and respiratory failure due to Mycoplasma pneumoniae pneumonia. Intern Med 41:229–232

    Article  PubMed  Google Scholar 

  • Vecchio R, Cacciola E, Cacciola RR et al (2011) Portal vein thrombosis after laparoscopic and open splenectomy. J Laparoendosc Adv Surg Tech A 21:71–75

    Article  PubMed  Google Scholar 

  • Willis F, Marsh JC, Bevan DH et al (2001) The effect of treatment with Campath-1H in patients with autoimmune cytopenias. Br J Haematol 114:891–898

    Article  PubMed  CAS  Google Scholar 

  • Worlledge SM, Brain MC, Cooper AC et al (1968) Immmunosuppressive drugs in the treatment of autoimmune haemolytic anaemia. Proc R Soc Med 61:1312–1315

    PubMed  CAS  Google Scholar 

  • Zaja F, Vianelli N, Sperotto A et al (2003) Anti-CD20 therapy for chronic lymphocytic leukemia-associated autoimmune diseases. Leuk Lymphoma 44:1951–1955

    Article  PubMed  CAS  Google Scholar 

  • Zantek ND, Koepsell SA, Tharp DR Jr et al (2012) The direct antiglobulin test: a critical step in the evaluation of hemolysis. Am J Hematol 87:707–709

    Article  PubMed  CAS  Google Scholar 

  • Zarandona JM, Yazer MH (2006) The role of the Coombs test in evaluating hemolysis in adults. CMAJ 174:305–307

    Article  PubMed  Google Scholar 

  • Zecca M, Nobili B, Ramenghi U et al (2003) Rituximab for the treatment of refractory autoimmune hemolytic anemia in children. Blood 101:3857–3861

    Article  PubMed  CAS  Google Scholar 

  • Zoppi M, Oppliger R, Althaus U et al (1993) Reduction of plasma cold agglutinin titers by means of plasmapheresis to prepare a patient for coronary bypass surgery. Infusionsther Transfusionsmed 20:19–22

    PubMed  CAS  Google Scholar 

  • Zupanska B, Sylwestrowicz T, Pawelski S (1981) The results of prolonged treatment of autoimmune haemolytic anaemia. Haematologia 14:425–433

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Internal Medicine Division, Department of Hematology, “Dr. José Eleuterio González” University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, Mexico

    José Carlos Jaime-Pérez, Marisol Rodríguez-Martínez, Andrés Gómez-de-León, Luz Tarín-Arzaga & David Gómez-Almaguer

  2. Servicio de Hematología, Edificio “Dr. Rodrigo Barragán”, 2 piso, Hospital Universitario “Dr. José E. González” Avenida Madero y Gonzalitos S/N, Colonia Mitras Centro, CP 64460, Monterrey, Nuevo León, Mexico

    José Carlos Jaime-Pérez

Authors
  1. José Carlos Jaime-Pérez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marisol Rodríguez-Martínez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrés Gómez-de-León
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Luz Tarín-Arzaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. David Gómez-Almaguer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to José Carlos Jaime-Pérez.

About this article

Cite this article

Jaime-Pérez, J.C., Rodríguez-Martínez, M., Gómez-de-León, A. et al. Current Approaches for the Treatment of Autoimmune Hemolytic Anemia. Arch. Immunol. Ther. Exp. 61, 385–395 (2013). https://doi.org/10.1007/s00005-013-0232-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00005-013-0232-3

Keywords

Search

Navigation