Autoimmune Hemolytic Anemia in Chronic Myeloid Leukemia

Abstract

Background: Autoimmune hemolytic anemia (AIHA) might be associated with underlying hematological malignancies such as chronic lymphocytic leukemia. However, the association between AIHA and chronic myelogenous leukemia is extremely unusual. Summary: We reviewed case reports and series of 54 patients with chronic myeloid leukemia (CML) who developed autoimmune hemolysis between 1952 and 2018. Almost all the patients were in the chronic phase and were classified into transplant and non-transplant groups. The onset of autoimmune hemolysis was earlier in the transplant group and required second-and third-line therapy to control it. The etiology of hemolysis is poorly understood but attributed in the transplant group to immune reconstitution, viral infections, or CML relapse. On the other hand, it is thought to be related in the non-transplant group to CML medications, especially interferon. Key Messages: Although AIHA is uncommon in chronic myelogenous leukemia patients, it should be in the differential diagnosis list for those who develop a sudden drop in hemoglobin without a bleeding source.

Autoimmune Complications in Hematologic Neoplasms

“…Its clinical features are extremely pleomorphic and may encompass virtually all organs and tissues, so that it is difficult to distinguish GVHD from other autoimmune complications post-HSCT. The latter include AICy, SLE and lupus-like reactions, systemic sclerosis, inflammatory bowel diseases, and autoimmune attack to central and peripheral nervous system [54,95,96]. The emergence of AID after HSCT has been systematically analysed only in patients transplanted for autoimmune diseases reporting a cumulative incidence of 9.8% at five years [97,98].…”

An aging mouse model of human chronic myeloid leukemia

“… 43 – 46 Some human CML patients receiving HSC transplantation or interferon therapy also develop anemia. 47 Although the underlying causes for anemia in CML patients and aging CML mice are not clear, it may be related to age, radiation, transplantation, therapy, and other age-related changes of bone marrow. 44 , 47 In this regard, aging mice may model human CML pathogenesis better than young mice.…”

Dasatinib-Induced Colitis with Rectal Sparing in a Patient with Chronic Myeloid Leukemia (Chronic Phase) on Dasatinib as an Upfront Therapy: Case Report

“…After stopping dasatinib treatment, our patient was started on imatinib; pros and cons were explained, and her questions were addressed as well; we encouraged the patient for treatment adherence in case of any adherence difficulty or problem (e.g., economic factor and medication side effect) and follow-up for close monitoring and dose adjustment since it can affect the treatment success [ 9 , 10 ]. Our group is studying the unmet clinical needs in Myeloproliferative neoplasms [ 11 ] and CML like cost effective analysis for second generations TKIs when used as upfront [ 12 ], the association of tuberclosis with CML [ 13 ], the reactivation of hepatitis B with CML [ 14 ], ophthalmic manifestations as initial presentation in patients with CML [ 15 ], Effects of intermittent fasting on CML [ 16 ], autoimmune hemolytic anemia and its association with different therapies in CML [ 17 ], priapism [ 18 , 19 ] and male fertility [ 20 ], as well as obesity [ 21 ] and obesity related surgeries in patients with CML [ 22 ].…”