[Long-term observation of patients with autoimmune hemolytic anemia]

Forty-nine cases of idiopathic and secondary autoimmune hemolytic anaemia (AIHA) were observed. Infections developed in 64% of them before the diagnosis of the idiopathic form had been established. In 83% of the patients warm antibodies were found, and in half these cases complement activation was observed on the blood cells. In 16% of cases autoantibodies to other tissues were present as well. Higher grade of anaemia and more severe course of the disease were observed in secondary AIHA. The survival time of patients with malignant lymphoma and haemolysis developing during the proliferation phase was twice as long as in cases with simultaneously diagnosed lymphoma and haemolysis. Idiopathic AIHA was more frequent chronic and mild. During over 2 years of follow-up haemolysis regressed in 44% of cases (in idiopathic AIHA in 65% and in secondary AIHA in 19%). The followed-up group comprised 36 patients. No immediate favourable effect of splenectomy was noted. In 43% of cases infections were a complication of pharmacological treatment and (or) splenectomy. Alloimmunization against blood cells was noted in 16% of cases.