Successful Treatment of Autoimmune Hemolytic Anemia with Steroid, IVIg, and Plasmapheresis in a Haploidentical Transplant Recipient

Autoimmune hemolytic anemia (AIHA) is a rare, but clinically significant complication following hematopoietic stem cell transplantation (HSCT). It is characterized by hemolysis due to antibodies produced by the donor’s immune system against donor red cell antigens. The 3-year cumulative incidence of AIHA is 4.44% in adults; however, 75% of patients develop AIHA during the first post-HSCT year [1]. AIHA after allogeneic HSCT has been associated with a variety of conditions, including chronic graft-versus-host disease (GVHD) [2], T-cell depletion [3], and unrelated donor transplants [4]. HSCT from unrelated donors and the development of chronic extensive GVHD were the only independent factors associated with AIHA [1]; however, the incidence of and risk factors for AIHA, as well as its prognosis and response to treatment remain unclear.