Paraneoplastic autoimmune cytopenias in Hodgkin lymphoma

Autoimmune cytopenias are typical paraneoplastic phenomena in malignant lymphomas. We assessed the occurrence, clinical, and laboratory features as well as the response to treatment of autoimmune hemolytic anemia, autoimmune thrombocytopenia, and neutropenia in published cases of Hodgkin lymphomas (HL). We identified 34 cases of an association between HL and autoimmune hemolytic anemia and 48 cases of an association of autoimmune thrombocytopenia (AITP) and HL. The autoimmune cytopenias (AIC) may occur prior to, concurrent with, at the time of recurrence of lymphoma or in complete remission after treatment. Almost all autoimmune hemolytic anemias were caused by warm antibodies. Patients with HL with AIC are more commonly males and are more likely to have mixed cellularity (MC) HL. HL is the only lymphoma which may be associated with autoimmune neutropenia. In contrast to AIC in diffuse large B-cell lymphoma (DLBCL), early stage is less common in patients with HL with AIC. AIC in HL respond better to antilymphoma treatment than to steroids, with the exception of post-treatment AITP in CR of HL which responds easily and durably to steroids.