Objective To analyze the clinical characteristics of lymphoma patients with autoimmune hemolytic anemia(AIHA), explore treatment efficacy, prognostic factors, and clinical treatment plans.
Method Clinical data of 18 patients with lymphoma complicated with AIHA who were treated in the Hematology Department of Xuzhou Medical University Affiliated Hospital from January 2011 to July 2023 were collected, and their clinical characteristics, treatment effects, and prognosis survival were retrospectively analyzed.
Result The median age of onset in 18 patients was 61 years old, including 12 males and 6 females. Ann Arbor staging included 4 cases in stage Ⅱ, 8 cases in stage Ⅲ, and 6 cases in stage Ⅳ. According to the different sources of immune phenotypes, there were 4 cases of T-cell lymphoma, 14 cases of B-cell lymphoma, among them 10 cases of diffuse large B-cell lymphoma. The AIHA antibody types of 18 patients were all warm antibody type, including 4 cases of IgG type, 5 cases of complement C3 type, and 7 cases of IgG + complement C3 type, and 2 patients was undetermined. The IgG level had statistical significance(P=0.042)in determining whether lymphoma patients have AIHA. The International Prognostic Index(IPI)score has statistical significance(P=0.011)in determining whether lymphoma patients have AIHA. After using the receiver operating characteristic (ROC) curve analysis, the optimal cutoff value for lactate dehydrogenase(LDH)was determined to be 400 U/L(P=0.002). After grouping them and conducting survival analysis using the Kaplan Meier method, it was found that LDH >400 U/L was an unfavorable prognostic factor affecting patient overall survival (OS). The gender of the patient being female was an unfavorable prognostic factor affecting OS and progression-free survival(PFS). The IPI score of high, medium, and high-risk groups(3~5 points)had a significant impact on OS. 18 patients had a 2-year OS of 50% and a 2-year PFS of 62.9%.
Conclusions Lymphoma combined with AIHA is rare in clinical practice and is more common in the elderly, mostly in stage Ⅲ~Ⅳ patients. Personalized treatment plans should be adopted based on the clinical characteristics of patients, and the prognosis mainly depends on the degree of remission of lymphoma. The overall prognosis of patients is poor.
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