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

Published version
Peer-reviewed

Type

Article

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Authors

Wang, Meng 
Wang, Wenjia 
Abeywardane, Ayesha 
Adikarama, Malinthi 
McLornan, Donal 

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.

Description

Keywords

Allogeneic hematopoietic stem cell transplantation, Autoimmune hemolytic anemia, Mortality, Adult, Anemia, Hemolytic, Autoimmune, Female, Hematologic Neoplasms, Hematopoietic Stem Cell Transplantation, Hospitals, University, Humans, Male, Middle Aged, Risk Factors, Siblings, Survival Analysis, Transplantation, Homologous, Treatment Outcome, United Kingdom, Unrelated Donors

Journal Title

Biol Blood Marrow Transplant

Conference Name

Journal ISSN

1083-8791
1523-6536

Volume Title

21

Publisher

Elsevier BV