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温抗体型自身免疫性溶血性贫血作为慢性髓系白血病的首发表现:一例报告

Warm Autoimmune Hemolytic Anemia as First Presentation of Chronic Myeloid Leukemia: A Case Report.

作者信息

Tawalbeh Ahmad, Al-Mashdali Abdulrahman, Al-Sabbagh Ahmad, Ellahi Anil Y, Yassin Mohamed A

机构信息

Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.

Department of Hematology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.

出版信息

Case Rep Oncol. 2024 Dec 3;17(1):1351-1357. doi: 10.1159/000542341. eCollection 2024 Jan-Dec.

Abstract

INTRODUCTION

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by the Philadelphia chromosome and uncontrolled granulocyte production. While autoimmune hemolytic anemia (AIHA) is commonly associated with lymphoproliferative disorders such as chronic lymphocytic leukemia, its occurrence in CML is rare, with only a few documented cases. Here, we report a case of concurrent chronic-phase CML and AIHA.

CASE PRESENTATION

We present a 34-year-old female diagnosed with warm AIHA as the first presentation of CML. Diagnostic workup, including peripheral smear, revealed hemolysis with elevated lactate dehydrogenase and a positive direct antiglobulin test (DAT), along with a positive Philadelphia chromosome, confirming CML. Steroid therapy successfully managed the AIHA, leading to normalization of hemoglobin levels and subsequent tapering and discontinuation of steroids.

CONCLUSION

While AIHA is a rare cause of anemia in CML, it should be considered during anemia evaluation, particularly in cases of CML relapse.

摘要

引言

慢性粒细胞白血病(CML)是一种骨髓增殖性肿瘤,其特征为费城染色体和粒细胞的失控性生成。自身免疫性溶血性贫血(AIHA)通常与慢性淋巴细胞白血病等淋巴细胞增殖性疾病相关,但其在CML中的发生较为罕见,仅有少数病例报道。在此,我们报告一例慢性期CML与AIHA并存的病例。

病例介绍

我们报告一名34岁女性,其首次表现为温抗体型AIHA,随后被诊断为CML。包括外周血涂片在内的诊断性检查显示存在溶血,乳酸脱氢酶升高,直接抗球蛋白试验(DAT)阳性,同时费城染色体阳性,确诊为CML。类固醇治疗成功控制了AIHA,使血红蛋白水平恢复正常,随后逐渐减少并停用类固醇。

结论

虽然AIHA是CML贫血的罕见原因,但在贫血评估时应予以考虑,尤其是在CML复发的病例中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af22/11614450/d7b3c2f372d6/cro-2024-0017-0001-542341_F01.jpg

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