Di Raimondo F, Giustolisi R, Cacciola E, O'Brien S, Kantarjian H, Robertson L B, Keating M J
Institute of Hematology, University of Catania, Italy.
Leuk Lymphoma. 1993 Sep;11(1-2):63-8. doi: 10.3109/10428199309054731.
Autoimmune hemolytic anemia (AHA) is a frequent complication of chronic lymphocytic leukemia (CLL). Although the pathogenesis of AHA is still unknown, an imbalance of normal residual T cells is believed to play a central role. Since fludarabine is reported to affect primarily T lymphocytes, we conducted a retrospective study to evaluate the incidence and outcome of AHA in 112 CLL patients treated with fludarabine alone. Eight patients had AHA before therapy; only one achieved remission of both CLL and AHA after fludarabine alone. In the other seven patients, we observed no effect or even a worsening of AHA, although the CLL was responding to fludarabine. Five patients developed AHA from 1 to 19 months after fludarabine therapy while the CLL was responding. One additional patient developed pure red cell aplasia (PRCA) 3 months after starting therapy. Most patients in both groups responded to steroids or other immunosuppressive therapy. The study showed that in these patients, AHA evolved independently of CLL and was not affected by fludarabine.
自身免疫性溶血性贫血（AHA）是慢性淋巴细胞白血病（CLL）常见的并发症。尽管AHA的发病机制尚不清楚，但正常残余T细胞的失衡被认为起核心作用。由于据报道氟达拉滨主要影响T淋巴细胞，我们进行了一项回顾性研究，以评估112例仅接受氟达拉滨治疗的CLL患者中AHA的发生率和转归。8例患者在治疗前就患有AHA；仅1例在单用氟达拉滨治疗后CLL和AHA均获缓解。在其他7例患者中，尽管CLL对氟达拉滨有反应，但我们观察到AHA无改善甚至恶化。5例患者在氟达拉滨治疗后1至19个月CLL有反应时发生AHA。另有1例患者在开始治疗3个月后发生纯红细胞再生障碍性贫血（PRCA）。两组中的大多数患者对类固醇或其他免疫抑制治疗有反应。该研究表明，在这些患者中，AHA独立于CLL演变，且不受氟达拉滨影响。
