Corticosteroids Combined with Cyclosporine a Is Superior to Corticosteroids As First-Line Treatment for Autoimmune Hemolytic Anemia after Allogeneic Hematopoietic Stem Cell Transplantation

We retrospectively investigated the incidence and outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients with autoimmune hemolytic anemia (AIHA). A total of 1,377 patients enrolled in this study, and the 3-year cumulative incidence of AIHA was 2.2±0.4%. Twenty-five patients with AIHA received treatment, including 15 patients who received corticosteroids combined with Cyclosporine A(CsA )and 10 who received corticosteroids monotherapy. After four weeks of treatment, the patients treated with corticosteroids combined with CsA had a higher complete response rate than those with corticosteroids monotherapy (66.7% vs. 11.1%; P=0.013). One patient (6.7%) experienced AIHA relapse in the combined group, and 5 (50.0%) relapsed in the monotherapy group (P=0.023). The 5-year cumulative incidence of malignant disease relapse was 5.5±5.1% and 27.4±1.4% (P=0.032), the OS was 86.3 ± 7.4% and 65.2 ± 1.6% (P=0.046), and the transplant-related mortality (TRM) post-transplantation was 9.3±6.4% and 22.8±1.6% (P=0.140), respectively, for patients with AIHA and those without AIHA. Our results indicate that corticosteroids combined with CsA is superior to corticosteroids as first-line treatment for AIHA, and AIHA does not contribute to increased primary disease relapse and TRM.