Diagnostic et prise en charge de l’anémie hémolytique auto-immune à l’exclusion des formes secondaires à une cause néoplasique. Adéquation de la prise en charge au PNDS octobre 2009

Lauda-Maillen, M.; Catroux, M.; Roy-Péaud, F.; Souchaud-Debouverie, O.; Masmouhi, B. El; Roblot, P.

doi:10.1016/j.revmed.2017.05.011

Cited by 3 publications

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“…IHA is also classified as primary, or idiopathic, when thereis no associated condition; or secondary when an underlying disorder can be identified: the latter is estimated to be about one-half of all cases of AIHA. Hematological malignancy is thought to be the number one cause of the secondary type [4]. However, patients with 'primary' AIHA may be seen to develop subsequently NHL, multiple myeloma, CLL or other lymphoid malignancies [5].…”

Section: Introductionmentioning

confidence: 99%

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2022

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Background: Hematological malignancies of the lymphoid lineage such as multiple myeloma, lymphomas and lymphoid leukemia are a burden to the world especially in Tanzania; anaemia is one of the presenting symptoms of these conditions and is found in almost 100% of the patients at diagnosis. Of particular importance Immune Hemolytic Anemia (IHA) which has a poor response to treatment and subsequently poor prognosis when it is associated with lymphoid malignancies. The aim of this study is to determine the magnitude of immune hemolytic anemia in lymphoid malignancies in Tanzania Methods: This was a cross sectional study that recruited 86 patients with lymphoid malignancies attending both Ocean Road Cancer Institute (ORCI) and Muhimbili National Hospital (MNH). The clinical features were captured using a well-structured questionnaire. Laboratory results for Full Blood Count (FBC), reticulocytes count, total, indirect and direct bilirubin and Lactate Dehydrogenase (LDH) were retrieved from the laboratory reporting system. Additionally, a blood sample for the Direct Antiglobulin Test (DAT) was taken from all participants. This test was performed at the Central Pathology Laboratory (CPL) of MNH. Data analysis was performed using Statistical Package for the Social Sciences (SPSS 20.0) and Microsoft excel 2010. Data analysis was performed using South Texas Art Therapy Association (STATA 15.0).Results: IHA, indicated by a positive DAT, was found in 10% of patients with lymphoid malignancies. Analysis of DAT among patients never exposed to chemotherapy showed a prevalence of 22%. Among 9 IHA cases, 2 were CLL (Chronic Lymphoid Leukaemia), 2 were MM (Multiple Myeloma), 3 was NHL (Non-Hodgkin Lymphoma), 1 was HL (Hodgkin Lymphoma) and 1 SLL (Small Lymphocytic Lymphoma). All 9 cases had decompensated hemolytic anemia. Conclusion:IHA is a real complication of chronic lymphoid malignancies and DAT should be included in tests done during the course of management.

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Section: Introductionmentioning

confidence: 99%

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2022

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How I manage patients with cold agglutinin disease

Berentsen

2018

Br J Haematol

111

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Cold agglutinin disease (CAD) is an uncommon autoimmune haemolytic anaemia in which a well-defined, clonal low-grade lymphoproliferative disorder of the bone marrow results in erythrocyte destruction mediated by the classical complement pathway. The pathogenesis, clinical features and diagnostic criteria are reviewed. Although anaemia is mild in some patients, approximately one-third of untreated patients have a haemoglobin level of ≤80 g/l, and about 50% have been considered transfusion dependent for shorter or longer periods. Therapy has improved greatly during the last 15 years. Mild disease can be managed by avoidance of cold and adequate precautions in specific situations, without drug therapy. Corticosteroids should not be used to treat CAD. Patients requiring pharmacological therapy should be considered for prospective trials. Outside clinical studies, the rituximab-bendamustine combination or rituximab monotherapy is recommended in the first line, depending on individual patient characteristics. Second-line options are rituximab-fludarabine in fit patients or, although less strongly documented, a bortezomib-based regimen. Therapies targeting the classical complement pathway are promising, and the complement C1s inhibitor, BIVV009, has shown favourable results in preliminary studies.

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Diagnostic et prise en charge de l’anémie hémolytique auto-immune à l’exclusion des formes secondaires à une cause néoplasique. Adéquation de la prise en charge au PNDS octobre 2009

Cited by 3 publications

References 16 publications

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Pristinamycin

How I manage patients with cold agglutinin disease

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