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lüll Immune hemolytic anemia--selected topics Hoffman PCHematology Am Soc Hematol Educ Program 2009[]; ä (ä): 80-6Autoimmune hemolytic anemia (AIHA) is most often idiopathic. However, in recent years, AIHA has been noted with increased incidence in patients receiving purine nucleoside analogues for hematologic malignancies; it has also been described as a complication of blood transfusion in patients who have also had alloimmunization. As the technology of hematopoietic stem cell transplantation has become more widespread, immune hemolysis in the recipients of ABO-mismatched products has become better recognized. The syndrome is caused by passenger lymphocytes transferred from the donor and, although transient, can be quite severe. A similar syndrome has been observed in recipients of solid organ transplants when there is ABO-incompatibility between donor and recipient. Venous thromboembolism is a little-recognized, though likely common, complication of AIHA, and may in some instances be related to coexistent antiphospholipid antibodies. While AIHA is a well-documented complication of malignant lymphoproliferative disorders, lymphoproliferative disorders may also paradoxically appear as a consequence of AIHA. A number of newer options are available for treatment of AIHA in patients refractory to corticosteroids and splenectomy. Newer immunosuppressives such as mycophenolate mofetil may have a role in such cases. Considerable experience has been accumulating in the last few years with monoclonal antibody therapy, mainly rituximab, in difficult AIHA cases; it appears to be a safe and effective option.|*Anemia, Hemolytic, Autoimmune/chemically induced/complications/drug therapy/immunology/surgery[MESH]|Adrenal Cortex Hormones/therapeutic use[MESH]|Antibodies, Monoclonal, Murine-Derived[MESH]|Antibodies, Monoclonal/therapeutic use[MESH]|Antimetabolites, Antineoplastic/adverse effects[MESH]|Blood Group Incompatibility/complications[MESH]|Cladribine/adverse effects[MESH]|Combined Modality Therapy[MESH]|Hematopoietic Stem Cell Transplantation/adverse effects[MESH]|Humans[MESH]|Immunoglobulins, Intravenous[MESH]|Immunosuppressive Agents/classification/therapeutic use[MESH]|Lymphocyte Subsets/immunology/transplantation[MESH]|Lymphoproliferative Disorders/complications[MESH]|Postoperative Complications/etiology[MESH]|Rituximab[MESH]|Splenectomy[MESH]|Transfusion Reaction[MESH]|Transplantation, Homologous/adverse effects[MESH]|Transplantation/adverse effects[MESH]|Venous Thromboembolism/etiology[MESH]|Vidarabine/adverse effects/analogs & derivatives[MESH] |