Severe autoimmune hemolytic anemia in eight patients treated with fludarabine.
We have used fludarabine to treat 36 patients with various lymphoid malignancies, including 29 with chronic lymphocytic leukemia (CLL). All these patients were heavily pretreated, and FAMP was prescribed on a compassionate basis. Eight patients (22%) developed severe autoimmune hemolytic anemia (AIHA) during or after treatment, and one died. Five patients had no previous history of hemolysis. These cases confirm the high incidence of AIHA after FAMP and suggest that the use of highly effective lymphocytotoxic agents such as fludarabine in heavily pretreated patients increases the risk of AIHA in CLL and other lymphoproliferative disorders.
Service d'Hématologie, Hôpital Pitié-Salpêtrière, Paris, France.
H
H
Gonzalez
V
V
Leblond
N
N
Azar
L
L
Sutton
J
J
Gabarre
J L
JL
Binet
J P
JP
Vernant
G
G
Dighiero
D000368:Aged; D000369:Aged, 80 and over; D000744:Anemia, Hemolytic, Autoimmune / Q000139:chemically induced* / Q000401:mortality / Q000628:therapy; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D017707:Erythrocyte Transfusion; D006461:Hemolysis / Q000187:drug effects / Q000276:immunology; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy / Q000401:mortality; D008875:Middle Aged; D015996:Survival Rate; D013997:Time Factors; D014740:Vidarabine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
D000970:Antineoplastic Agents; D014740:Vidarabine; C024352:fludarabine