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Autoimmune hemolytic anemia: transfusion challenges and solutions

Authors Barros MM, Langhi Jr DM, Bordin JO

Received 2 February 2016

Accepted for publication 8 May 2016

Published 16 March 2017 Volume 2017:5 Pages 9—18

DOI https://doi.org/10.2147/IJCTM.S81870

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Prof. Dr. Cees Th. Smit Sibinga


Melca M O Barros, Dante M Langhi Jr, José O Bordin

Department of Clinical and Experimental Oncology, Universidade Federal de São Paulo, São Paulo, Brazil

Abstract: Autoimmune hemolytic anemia (AIHA) is defined as the increased destruction of red blood cells (RBCs) in the presence of anti-RBC autoantibodies and/or complement. Classification of AIHA is based on the optimal auto-RBC antibody reactivity temperatures and includes warm, cold-reactive, mixed AIHA, and drug-induced AIHA subtypes. AIHA is a rare disease, and recommendations for transfusion are based mainly on results from retrospective data and relatively small cohort studies, including heterogeneous patient samples or single case reports. In this article, we will review the challenges and solutions to safely transfuse AIHA patients. We will reflect on the indication for transfusion in AIHA and the difficulty in the accomplishment of immunohematological procedures for the selection of the safest and most compatible RBC units.

Keywords: hemolytic anemia, RBC autoantibodies, autoimmunity, hemolysis, direct ­antiglobulin test

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