[Treatment practice and outcomes in 125 patients with autoimmune hemolytic anemia: a single-center retrospective...

Objective: To explore the clinical characteristics, treatment patterns, and outcomes of patients with autoimmune hemolytic anemia (AIHA) in a single-center retrospective cohort. Methods: Clinical data of 125 patients with AIHA admitted to the Blood Diseases Hospital, Chinese Academy of Medical Sciences, between July 2019 and February 2025, were retrospectively analyzed to investigate their clinical characteristics, treatment patterns, and outcomes. Results: Glucocorticoid monotherapy was the most commonly administered first-line treatment, whereas 78.2% of the patients received glucocorticoids in combination with rituximab during the disease course. The overall response rate (ORR) and the sustained remission rate were 61.3% and 10.7% in 75 patients receiving glucocorticoid monotherapy as first-line treatment and 88.0% and 60.0% in 25 patients treated with glucocorticoids plus rituximab, respectively. The median number of treatment lines was two, with approximately one-third of the patients requiring three or more lines of therapy. In the context of clinical research, 27 (21.6%) patients with relapsed/refractory disease received exploratory treatment with novel targeted agents, with a significantly higher median number of treatment lines compared with those who did not [4 (2-12) vs 2 (1-6), P<0.001]. After treatment, 44.4% of patients achieved remission, whereas 40.7% of patients had their HGB levels normalized. Regarding complications, venous thromboembolism occurred in 8 patients (6.4%). Further, 36 patients (28.8%) developed infections, with a significantly higher number of treatment lines in the infection group than in the noninfection group (P<0.001) . Conclusion: The therapeutic approaches for AIHA demonstrate remarkable heterogeneity. Glucocorticoid monotherapy remains the most commonly administered first-line treatment; however, its ability to maintain sustained remission is limited. Glucocorticoid treatment in combination with rituximab demonstrated a higher ORR and sustained remission rate. Patients who developed infections during the disease course required significantly more lines of therapy, emphasizing the importance of infection prevention and surveillance in clinical practice.