melphalan and Anemia--Hemolytic--Autoimmune

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Anemia; Anemia, Hemolytic, Autoimmune; Blood Urea Nitrogen; Glucocorticoids; Humans; Hypercalcemia; Immunoglobulins; Leukemia; Lymphoma; Melphalan; Multiple Myeloma; Myeloma Proteins; Prednisone; Waldenstrom Macroglobulinemia

Topics: Aged, 80 and over; Anemia, Hemolytic, Autoimmune; Antigens, CD; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow; Bortezomib; Clonal Evolution; Clone Cells; Cyclophosphamide; Dexamethasone; Disease Progression; Female; Humans; Immunosuppressive Agents; Leukemia, Lymphocytic, Chronic, B-Cell; Leukemia, Plasma Cell; Lymphocytosis; Melphalan; Prednisolone; Rituximab

Life-threatening haemolysis in children with autoimmune haemolytic anaemia (AIHA) occurs rarely. Many cases of severe autoimmune disease are currently treated with immunosuppressive high-dose chemotherapy and autograft. We report here a case of a child with severe AIHA who did not respond to conventional treatments, but was cured with an autologous peripheral blood CD34(+) cell transplantation. After d 16 post autograft, no further red cell transfusions were required. At 20 months post autograft, haematological complete remission persists.

Topics: Anemia, Hemolytic, Autoimmune; Antigens, CD34; Antineoplastic Combined Chemotherapy Protocols; Carmustine; Child; Cyclophosphamide; Cytarabine; Hematopoietic Stem Cell Mobilization; Hematopoietic Stem Cell Transplantation; Humans; Immunoglobulins, Intravenous; Immunosuppressive Agents; Male; Melphalan; Methylprednisolone; Plasmapheresis; Podophyllotoxin; Prednisolone; Splenectomy; Stem Cells; Transplantation, Autologous; Treatment Outcome

A 66-year-old female was admitted to our hospital with lumbago. On admission, laboratory examination revealed hemolytic anemia. Direct Coombs' test was positive, and also direct monospecific-Coombs' test by anti-C3d serum was positive. Immunoelectrophoresis showed IgA-lambda type M proteins in serum. Bone marrow aspiration disclosed increased atypical plasma cells. X-ray of skull showed punched-out lesion. From these findings, she was diagnosed as IgA (lambda) myeloma complicating with autoimmune hemolytic anemia. Hemolysis was improved by chemotherapy. It was thought that IgA and C3 were related well to hemolysis in this case.

Topics: Aged; Anemia, Hemolytic, Autoimmune; Antineoplastic Combined Chemotherapy Protocols; Cyclophosphamide; Female; Humans; Immunoglobulin A; Immunoglobulin lambda-Chains; Melphalan; Multiple Myeloma; Prednisolone

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Aged; Alkylating Agents; Anemia, Hemolytic, Autoimmune; Azathioprine; Chlorambucil; Cyclophosphamide; Drug Evaluation; Female; Follow-Up Studies; Humans; Male; Melphalan; Middle Aged; Prednisone; Splenectomy