title: [An analysis of relapse and risk factors of autoimmune hemolytic anemia and Evans syndrome].
abstract: OBJECTIVE
  To analyse the relapse rate and risk factors of autoimmune hemolytic anemia (AIHA) and Evans syndrome.
  
  
  METHODS
  Fifty two cases of AIHA and Evans syndrome in remission being followed up for 1 - 14 years (median time 3.8 years) were analysed for relapse rate. The risk factors of relapse were analysed by case-control study.
  
  
  RESULTS
  The total relapse rate of these AIHA and Evans syndrome patients was 57.7%, and the median remission duration to the first relapse was 9 months. The relapse rates in patients with negative Coombs test, warm autoantibodies and both of warm and cold autoantibodies were 30.8% (4/13), 54.0% (13/24) and 86.7% (13/15), respectively. The relapse rate in patients with cold antibody was the highest (P < 0.05). The relapse rate in patients with antibody titer >or= 100 was 92.9% (13/14) and was higher than that in patients with antibody titer < 100 [59.5% (13/22)] (P < 0.05). Patients treated with prednisone and cyclosporin relapsed less than those treated with prednisone alone, and the relapse was related to the therapy course of prednisone and CsA.
  
  
  CONCLUSIONS
  Because of the high relapse rate, AIHA and Evans syndrome should be treated according to the class of autoantibodies, and with longer course of prednisone and cyclosporin and prophylaxis of infection.
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
authors.forename: Zong-hong
authors.initials: ZH
authors.lastname: Shao
authors.forename: Zhen-zhu
authors.initials: ZZ
authors.lastname: Cui
authors.forename: Yu-hong
authors.initials: YH
authors.lastname: Wu
authors.forename: Tie-jun
authors.initials: TJ
authors.lastname: Qin
authors.forename: Rong
authors.initials: R
authors.lastname: Fu
authors.forename: Guang-sheng
authors.initials: GS
authors.lastname: He
authors.forename: Jun
authors.initials: J
authors.lastname: Shi
authors.forename: Jie
authors.initials: J
authors.lastname: Bai
authors.forename: Yan-ran
authors.initials: YR
authors.lastname: Cao
authors.forename: Chong-li
authors.initials: CL
authors.lastname: Yang
authors.forename: Tian-ying
authors.initials: TY
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000209:etiology* / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D002648:Child; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D012008:Recurrence; D012307:Risk Factors; D013577:Syndrome; D013921:Thrombocytopenia / Q000209:etiology* / Q000276:immunology
chemical_list: D001323:Autoantibodies; D016572:Cyclosporine; D011241:Prednisone