Journal
JOURNAL OF BLOOD MEDICINE
Volume 10, Issue -, Pages 265-278Publisher
DOVE MEDICAL PRESS LTD
DOI: 10.2147/JBM.S190327
Keywords
autoimmune hemolytic anemia; allogeneic hematopoietic stem cell transplantation; rituximab; sirolimus and abatacept; bortezomib and daratumumab
Categories
Funding
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico [RC 2018-19]
Ask authors/readers for more resources
Autoimmune hemolytic anemia (AIHA) is increasingly observed after allogeneic hematopoietic stem cell transplantation (allo-HSCT), with a reported incidence between 4% and 6%. The disease is generally severe and refractory to standard therapy, with high mortality, and there are neither defined therapies, nor prospective clinical trials addressing the best treatment. Most of the knowledge on the therapy of AIHAs derives from primary forms, which are highly heterogeneous as well, further complicating the management of post-allo-HSCT forms. The review addresses the risk factors associated with post-allo-AIHA, including unrelated donor, the development of chronic extensive graft-versus-host disease, CMV reactivation, nonmalignant diagnosis pre-HSCT, and alemtuzumab use in conditioning regimens. Regarding therapy, we describe standard treatments, such as corticosteroids, intravenous immunoglobulin, splenectomy, rituximab, cyclophosphamide, and plasma exchange, which have lower response rates than those reported in primary forms. New therapeutic options, including sirolimus, bortezomib, abatacept, daratumumab and complement inhibitors, are promising tools for this detrimental complication occurring after allo-HSCT.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available