[An analysis of relapse and risk factors of autoimmune hemolytic anemia and Evans syndrome].
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.
Liu
Hong
H
Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China.
Shao
Zong-hong
ZH
Cui
Zhen-zhu
ZZ
Wu
Yu-hong
YH
Qin
Tie-jun
TJ
Fu
Rong
R
He
Guang-sheng
GS
Shi
Jun
J
Bai
Jie
J
Cao
Yan-ran
YR
Yang
Chong-li
CL
Yang
Tian-ying
TY
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
D001323:Autoantibodies; D016572:Cyclosporine; D011241:Prednisone