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Pathogenesis, risk factors and therapeutic options for autoimmune haemolytic anaemia in the post-transplant setting

Gabelli, M; Ademokun, C; Cooper, N; Amrolia, PI; (2022) Pathogenesis, risk factors and therapeutic options for autoimmune haemolytic anaemia in the post-transplant setting. British Journal of Haematology , 196 (1) pp. 45-62. 10.1111/bjh.17648. Green open access

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Abstract

Autoimmune haemolytic anaemia (AIHA) is a rare complication of allogeneic haematopoietic stem cell transplantation (HSCT), observed with an incidence of 1–5%. Paediatric age, diagnosis of non-malignant disease, lympho-depleting agents in the conditioning regimen, use of unrelated donor, graft versus host disease and infections have been associated with a higher risk of AIHA post HSCT. Post-HSCT AIHA is associated with high mortality and morbidity, and it is often very difficult to treat. Steroids and rituximab are used with a response rate around 30–50%. These and other therapeutic strategies are mainly derived from data on primary AIHA, although response rates in post-HSCT AIHA have been generally lower. Here we review the currently available data on risk factors and therapeutic options. There is a need for prospective studies in post-HSCT AIHA to guide clinicians in managing these complex patients.

Type: Article
Title: Pathogenesis, risk factors and therapeutic options for autoimmune haemolytic anaemia in the post-transplant setting
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/bjh.17648
Publisher version: https://doi.org/10.1111/bjh.17648
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Autoimmune haemolytic anaemia, haematopoietic stem cell transplantation, autoimmunity, primary immunodeficiency, rituximab
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10133425
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