Evaluation of Patients Diagnosed with Autoimmune Hemolytic Anemia in Terms of Etiology and Treatment: a single center experience

Öz

This study aimed to evaluate the etiological factors, clinical and laboratory characteristics, and treatment responses of patients diagnosed with autoimmune hemolytic anemia (AIHA) at Eskişehir Osmangazi University Faculty of Medicine, Department of Internal Medicine. In this retrospective study, data of 91 patients diagnosed with AIHA between January 1, 2017, and January 1, 2025, were analyzed. Demographic features, serological subtypes, comorbidities, laboratory values, treatment approaches, and clinical outcomes were assessed using hospital records. Of the patients, 63.7% were female, with a median age of 57.3±18.5 years. The distribution of serological subtypes was: warm-type AIHA 46.2%, cold agglutinin disease (CAD) 17,5%, and mixed-type AIHA 36.3%. Secondary AIHA was present in 62.6% of patients, with the most common causes being lymphomas (13.2%), systemic lupus erythematosus (11%), and chronic lymphocytic leukemia (11%). The relapse rate was 19.8%, most frequently observed in mixed-type AIHA. Thromboembolic events occurred in 11% of patients, especially in older individuals. Among patients with primary AIHA, 61.8% received corticosteroids as first-line therapy, with a complete response achieved in 82.4%. Rituximab was administered as second-line therapy in 5 patients, yielding a 60% response rate. AIHA is a heterogeneous disorder in which identifying secondary causes and serological subtypes plays a critical role in diagnosis and treatment. While warm type AIHA is the most common form, mixed-type cases tend to be more resistant to treatment. In conclusion, effective therapy and close monitoring are essential in reducing relapse and thromboembolic complications.

Anahtar Kelimeler

• Autoimmune hemolytic anemia
• warm treatment response
• thrombosis

Otoimmün Hemolitik Anemi Tanılı Hastalarımızın Etiyoloji ve Tedavi Açısından Değerlendirilmesi: Tek Merkez Deneyimi

Öz

Bu çalışmada, Eskişehir Osmangazi Üniversitesi Tıp Fakültesi İç Hastalıkları Anabilim Dalı’nda takip edilen otoimmün hemolitik anemi (OİHA) tanılı hastaların etiyolojik nedenleri, klinik ve laboratuvar özellikleri ile tedavi yanıtları değerlendirilerek literatüre katkı sağlanması amaçlanmıştır. Çalışma, 1 Ocak 2017- 1 Ocak 2025 tarihleri arasında OİHA tanısı konulmuş 91 hastanın retrospektif olarak değerlendirilmesi ile gerçekleştirilmiştir. Veriler hasta dosyalarından elde edilmiş; demografik bilgiler, serolojik alt tip dağılımları, komorbiditeler, laboratuvar değerleri, tedavi protokolleri ve klinik sonuçlar analiz edilmiştir. Hastaların %63,7’si kadın olup, medyan yaş 57,3±18,5 yıl olarak saptanmıştır. Serolojik alt tip dağılımı sıcak tip OİHA %46,2, soğuk aglütinin hastalığı (SAH) %17,5 ve karma tip OİHA %36,3 şeklindedir. Hastaların %62,6’sı sekonder OİHA olup, en sık eityolojik nedenler lenfomalar (%13,2), sistemik lupus eritematozus (SLE) (%11) ve kronik lenfositik lösemi (KLL) (%11) olarak belirlenmiştir. Relaps oranı %19,8 olup, en sık karma tip OİHA’da görülmüştür. Tromboembolik olay oranı %11 olup, özellikle ileri yaş hastalarda daha sık saptanmıştır. Primer OİHA hastalarının %61,8’i birinci basamakta steroid tedavisi almış, %82,4’ünde tam yanıt elde edilmiştir. İkinci basamakta rituksimab kullanılan hastalarda ise %60’lık yanıt oranı gözlenmiştir. OİHA heterojen yapıda bir hastalık olup, özellikle sekonder nedenlerin ve serolojik alt tiplerin belirlenmesi, tanı ve tedavi sürecinde büyük önem taşımaktadır. Sıcak tip OİHA en sık görülen alt tip olmakla birlikte, karma tip olgular daha dirençli seyretmektedir. Etkin tedavi ve yakın izlem, relaps ve tromboembolik olayları azaltmada kritik rol oynamaktadır.

Anahtar Kelimeler

• Otoimmün hemolitik anemi
• tedavi yanıtı
• tromboz

Kaynakça

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