Department of Research and Innovation, Haugesund Hospital, Helse Fonna Hospital Trust, Haugesund, Norway.
Curr Oncol Rep. 2024 Sep;26(9):1085-1096. doi: 10.1007/s11912-024-01569-8. Epub 2024 Jun 14.
Cold-antibody mediated autoimmune hemolytic anemia (cAIHA) is subclassified as cold agglutinin disease (CAD), secondary cold agglutinin syndrome (CAS), and paroxysmal cold hemoglobinuria (PCH). This review aims to address the occurrence of neoplastic disorders with these three entities and analyze the impact of such neoplasias on treatment for cAIHA.
"Primary" CAD is a distinct clonal B-cell lymphoproliferative disorder in probably all cases, although not classified as a malignant lymphoma. CAS is secondary to malignant lymphoma in a minority of cases. Recent findings allow a further clarification of these differential diagnoses and the therapeutic consequences of specific neoplastic entities. Appropriate diagnostic workup is critical for therapy in cAIHA. Patients with CAD should be treated if they have symptomatic anemia, significant fatigue, or bothersome circulatory symptoms. The distinction between CAD and CAS and the presence of any underlying malignancy in CAS have essential therapeutic implications.
冷抗体介导的自身免疫性溶血性贫血（cAIHA）分为冷凝集素病（CAD）、继发性冷凝集素综合征（CAS）和阵发性冷性血红蛋白尿症（PCH）。本综述旨在探讨这三种疾病与肿瘤性疾病的发生情况，并分析这些肿瘤对 cAIHA 治疗的影响。
“原发性”CAD 可能在所有病例中都是一种独特的克隆性 B 细胞淋巴增生性疾病，尽管不被归类为恶性淋巴瘤。少数情况下，CAS 继发于恶性淋巴瘤。最近的发现进一步明确了这些鉴别诊断以及特定肿瘤实体的治疗后果。适当的诊断性检查对于 cAIHA 的治疗至关重要。如果 CAD 患者出现症状性贫血、明显疲劳或烦人的循环症状，应进行治疗。CAD 和 CAS 的区别以及 CAS 中是否存在任何潜在恶性肿瘤具有重要的治疗意义。
