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Abstract
A 29 years old female with chronic myelogenous leukemia underwent an unmanipulated, unrelated, HLAmatched peripheral blood stem cell transplantation (PBSCT) after imatinib mesylate treatment. The patient and donor had different ABO blood types and at 1 year later after PBSCT, the patient showed severe autoimmune hemolytic anemia (AIHA). She was treated with several immunosuppressive agents including high-dose steroid, cyclophosphamide, intravenous immunoglobulin and rituximab and underwent multiple sessions of plasma exchange. As her AIHA showed no response to these multiple therapies, she underwent splenic artery embolization and splenectomy. After then her AIHA was resolved with low dose oral steroid maintenance. Although the incidence of AIHA is known to be increased after allogeneic hematopoietic stem cell transplantation (HSCT), it has been rarely reported in Korea. Since AIHA in the setting of post-allogeneic HSCT is often difficult to treat and the prognosis is very poor, the accurate and early diagnosis is needed.
Figures and Tables
Fig. 1
Peripheral blood smears at the time of diagnosis of autoimmune hemolytic anemia. (A) Representative photomicrograph (magnification, ×200) demonstrates marked anisocytosis with reticulocytosis. (B) There are many spherocytes (arrows) with leukoerythroblastosis representing severe hemolytic condition (magnification, ×400).
References
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