AUTOIMMUNE HEMOLYTIC-ANEMIA ASSOCIATED WITH CANCER

Twelve patients with autoimmune hemolytic anemia (AIHA) associated with carcinoma are presented. Ten were affected with anemia during the course of the neoplastic disease. In two patients, severe autoimmune hemolysis manifested the presence of cancer. Corticosteroid therapy, successfully employed in idiopathic AIHA, was ineffective or showed only an initial partial response. In one case, therapy for carcinoma with chemo-radiotherapy led to the disappearance of antibodies and anemia. In two cases, surgical removal of the tumor caused remission of the AIHA. The possibility of an occult tumor in patients with apparently idiopathic AIHA and the possible autoimmune etiology of anemia in cancer should therefore be considered although the pathogenic mechanisms of autoimmune hemolytic disease in cancer patients has still not been well defined.