Author/Authors :
Nazel Khosroshahi، Behzad نويسنده Emam Reza Hospital, Hamadan University of Medical Sciences, Hamadan, Iran ; Blood transfusion research center, High institute for research and Education in Transfusion Medicine, Tehran, Iran. Nazel Khosroshahi, Behzad , Jafari، Mohammad نويسنده , , Vazini، Hossein نويسنده Department of Nursing, Hamadan Branch, Islamic Azad University, Hamadan, Iran. , , Ahmadi، Alireza نويسنده , , Shams، Keivan نويسنده Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Shams, Keivan , Kholoujini، Mahdi نويسنده Department of Mycology, School of Medicine, Tarbiat Modares University, Tehran, Iran. Kholoujini, Mahdi
Abstract :
Autoimmune hemolytic anemia (AIHA) is characterized by shortening of red blood cell (RBC) survival and the presence of autoantibodies directed against autologous RBCs. Approximately 20% of autoimmune hemolytic anemia cases are associated with cold-reactive antibody. About half of patients with AIHA have no underlying associated disease; these cases are termed primary or idiopathic. Secondary cases are associated with underlying diseases or with certain drugs. We report herein a rare case of cold autoimmiune hemolytic anemia due to high-grade non-Hodgkinʹs lymphoma of B-cell type with weak response to rituximab and chemotherapy regimens. For treatment B cell lymphoma, Due to lack of treatment response, we used chemotherapy regimens including R- CHOP for the first time, and then Hyper CVAD, R- ICE and ESHAP were administered, respectively. For treatment of autoimmune hemolytic anemia, we have used the corticosteroid, rituximab, plasmapheresis and blood transfusion and splenectomy. In spite of all attempts, the patient died of anemia and aggressive lymphoma nine months after diagnosis. To our knowledge, this is a rare report from cold autoimmune hemolytic anemia in combination with high-grade non-Hodgkinʹs lymphoma of B-cell type that is refractory to conventional therapies.
