Abstract:
Objective To investigate the clinical characteristics of diffuse large B-cell lymphoma (DLBCL) combined with autoimmune hemolytic anemia (AIHA).
Methods Data of six patients with DLBCL complicated by AIHA treated at the First Affiliated Hospital of Wannan Medical College between January 2012 and December 2018 were retrospectively reviewed. The clinical manifestations, laboratory results, treatment and follow-up results were analyzed.
Results Of these six patients with DLBCL complicated by AIHA, 2 patients were males and 4 were females, aged between 49 and 73 years old, with a median age of 60 years old. Their median level of hemoglobin was 69.5 (55-85) g/L, the medical ratio of reticulocytes was 6.65% (1.2%-14.7%), and the Coombs test positive rate was 100%. Of the 6 patients, 4 presented with stage Ⅲ and 2 stage Ⅳ DLBCL. Four patients had an International Prognostic Index (IPI) of 3, 1 was IPI 4, and 1 was IPI 5. The diagnosis of AIHA preceded that of DLBCL in 2 patients. Contrastingly, in 4 patients, AIHA occurred either when DLBCL was diagnosed or during the course of the disease. Four patients received prednisone between the chemotherapy intermittent period, and 2 patients received only chemotherapy. Of the 6 patients, 3 passed away. The median overall survival (OS) time was 17 months.
Conclusions AIHA remains a rare occurrence in patients with DLBCL. The treatment schedule should be personalized based on the patient's onset status and therapeutic effect. Prognosis depends largely on the response status of the diffuse large B-cell lymphoma.