Table 1.
Case reports and case series of AIHA in CML patients (TKI was not used as part of CML therapy)
| 1st author | Year of publication | Age, years/gender | CML phase | CML therapy | AIHA onset | Hb, g/dL | AIHA therapy | Duration of therapy | Hb, g/dL − follow-up | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|
| Osgood E. [6] | 1952 | N/A | Chronic | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
| Vidbaek A. [7] | 1962 | 70/F | N/A | 12 mo | 6.4 | Prednisone 40 mg | 2 wk | Died with aspergillus sepsis | ||
| 48/F | Chronic | Radiotherapy | 9 mo (both after CML diagnosis) | 3.4 | Prednisone 40 mg | 1 wk | N/A | Died with blast crisis after 3 mo | ||
| Maldonado N.I. [8] | 1967 | 84/M | Chronic | Busulfan intermittent use | 12 mo (after CML diagnosis) | 7 | Prednisone 50 mg | 1 mo (tapered) | 8.9 | Died with pneumonia after 1 mo |
| Cohen S.M [9] | 1967 | 45/F | Chronic | Busulfan for 2 wk | 4 yr* | 5 | Prednisone 60 mg | 6 mo (tapered) | 13 | Improved |
| Arbaje Y.M. [10] | 1990 | 55/M | Chronic | Busulfan intermittent use | 3 yr (after CML diagnosis) | 8 | Prednisone | 5 wk | 14 | Improved |
| Klumpp T.R. [11] | 1990 | 47/F | Chronic | Allogenic BMT† | 19 mo (after BMT) | N/A | Steroids | N/A | N/A | Improved |
| Tamura T. [12] | 1994 | 36/M | Chronic | Allogenic BMT† | CAD 3 wk (after BMT) | N/A | Prednisolone | N/A | N/A | Improved |
| Sacchi S. [13] | 1995 | 7 patients: 42 (median)/6 F, 1 M | Chronic | IFN-α-2a IFN-α-2b for 14 mo (median) | 10 mo (median after CML diagnosis) | 7.6 (mean) | Prednisone (3 patients) Splenectomy (1 patient) | N/A | N/A | Improved |
| Andriani A. [14] | 1996 | 59/F 59/F |
Chronic | IFN-α-2b for 27 mo IFN-α-2a for 38 mo | N/A | 7.7 7 |
Prednisone (0.5–1 mg/kg) | 1–3 mo | N/A | Improved |
| Chen F.E. [15] | 1997 | 36/M 56/M 34/F 41/M 31/M |
Chronic | Allogenic BMT | (12, 8, 7, 2, 2) mo (Post-BMT) 3 AIHA 2 AIHA and CAD |
N/A | Prednisolone (4 patients) IVIg (3 patients) Splenectomy + vincristine (1 patient) No treatment (1 patient) |
N/A | N/A | Improved (3 patients) CML relapse (3 patients) Died (3 patients) with pneumonitis/thrombo-embolisms/GVHD |
| Stavroyianni N. [16] | 2001 | 27/M | Chronic | IFN-α-2b and hydroxyurea | 2 yr (post-CML diagnosis) | 5.3 | Prednisone | 1 mo | N/A | Improved |
| Cwynarski K. [17] | 2001 | 9 patients: 32 (median)/6 M, 3 F | Chronic | Allogenic BMT | 15 mo (median − post-BMT) | N/A | Prednisolone + IVIg (9 patients) Splenectomy (4 patients) Donor lymphocyte infusion (5 patients) | Variable (1–10 mo) | N/A | Improved (6 patients) Died with pneumonitis (2 patients) |
| Köksal A. [18] | 2002 | 41/F | Chronic | IFN-α | 5 yr (post-CML diagnosis) | 5.5 | Prednisone (1 mg/kg) | 1 mo | 9 | Died with ICH and pneumonia |
| Tóthová E. [19] | 2002 | 2 patients | Chronic | IFN-α† | N/A | N/A | N/A | N/A | N/A | N/A |
| Steegmann J.L. [20] | 2003 | 37/M | Chronic | IFN-α-2a for 4 yr | 4 yr CAD (post-CML diagnosis) | N/A | N/A | N/A | N/A | N/A |
| Qazilbash M.H. [21] | 2005 | 21/F | Chronic | Allogenic HSCT | 3 mo post-SCT AIHA and CAD | N/A | Methylprednisolone (1 mg/kg) IVIg (0.5 g/kg) for 4 d Plasmapheresis for 2 wk Rituximab (375 mg/m2) |
- | N/A | Died with fulminant liver failure |
| Sanz J. [22] | 2007 | 22/M 52/F 42/F 38/M |
Chronic | UCBT (2 patients) BMT (2 patients) | 1, 5, 10, and 17 mo posttransplant 2 AIHA 2 CAD | N/A | Not specified for CML cases | N/A | N/A | Not specified for CML cases |
| Calixto R. [23] | 2012 | 47/F | Accelerated | Allogenic PBSCT | 8 d post-PBCST | 5 | Méthylprednisolone (2 mg/kg) | 2 mo (tapered) | N/A | Improved |
| Sanz J. [24] | 2014 | 4 patients: 33 (median)/N/A | Chronic | Allogenic UCBT | 7.6 mo (median posttransplant) 1 AIHA 3 CAD | N/A | Not specified for CML cases | N/A | N/A | 2 patients died with sepsis |
| Yang Z. [25] | 2014 | 26/F | Chronic | Allogenic HSCT | 3.6 mo posttransplant | N/A | Not specified for CML case | N/A | N/A | Not specified for CML case |
| Wang M. [26] | 2015 | 49/M 34/M |
Chronic | Allogenic HSCT | 6 and 7 mo post-SCT | N/A | Prednisolone Rituximab Cyclosporine Splenectomy IVIg |
N/A | N/A | No improvement Died with AIHA Improved |
AIHA, autoimmune hemolytic anemia; BMT, bone marrow transplantation; CAD, cold agglutinin disease; GVHD, graft versus host disease; CML, chronic myeloid leukemia; d, day; Hb, hemoglobin; HSCT, hematopoietic stem cell transplantation; ICH, intracranial hemorrhage; IFN-α, interferon alpha; IVIg, intravenous immunoglobulin; F, female; M, male; mo, month; N/A, not available; PBSCT, peripheral blood stem cell transplantation; SCT, stem cell transplantation; TKI, tyrosine kinase inhibitor; UCBT, umbilical cord blood transplantation; wk, week; yr, year.
*
The onset of AIHA was prior to CML.† Abstract only was available.