Cellular basis of autoimmune hemolytic anemia.

Autoimmune hemolytic anemia (AIHA) is produced by the in vivo destruction of red cells coated with auto-antibodies which are produced by naturally occurring B-lymphocytes. The auto-antibody-producing cells are under the control of suppressor T-lymphocytes whose activity may be deficient in patients with AIHA. The ultimate cure of AIHA will probably reside in the reestablishment of the normal control of the autoantibody-producing cells and not in the elimination of the cells responsible for the destruction of the antibody-coated cells by splenectomy or drug therapy. The cells responsible for destruction of red cells are necessary for the removal of other antibody-coated particles (such as bacteria, etc.). The removal or inactivation of tissue macrophages predisposes the patient to other serious problems including the possibility of serve sepsis. The reestablishment of normal control of the auto-antibody-producing cells by the normalization of the patient's suppressor cell status may be a safer mode of therapy for autoimmune hemolytic anemia in the future.