Study of five cases of autoimmune hemolytic anemia in the course of hemoblastosis (author's transl)

Abstract

Five cases of AHA in the course of different hemoblastosis (lymphosarcoma, Hodgkin's disease, CLL, AML) are described. Three cases presented no reticulocytosis and no hemolysis, ascribed to erythropoietic insufficiency due to neoplastic proliferation and/or cytostatic therapy in two cases and myeloid aplasia, probably due to the fixation to the bone marrow cells by erythrocytes and platelet autoantibodies in another case. In the two lymphosarcoma cases erythrocyte autoantibodies were found in the course of pretransfusion crossmatching. It may be inferred that systematic immunological tests can reveal erythrocyte autoimmunization in the course of anemia due to a hemoblastosis, even when there are no signs of hemolysis. Erythrocyte-fixed antibodies were of the IgG, IgA, IgM types in various combinations in different patients; the two cases with lymphosarcoma presented a high titer of cold anti I hemoagglutinins. In view of the frequency of both AHA and lymphoproliferative disorders in patients with immunological disorders, it is suggested that neoplasms and autoimmune diseases are independent phenomena, both conditioned by an immunological deficiency, influencing autoantibody synthesis and/or neoplastic growth.