title: Autoimmune hemolytic anemia and autoimmune thrombocytopenia at diagnosis and during follow-up of Hodgkin lymphoma.
abstract: Autoimmune hemolytic anemia and thrombocytopenia (AIHA/AITP) frequently complicate the course of non-Hodgkin lymphomas, especially low-grade, but they are very rarely observed in Hodgkin lymphoma (HL). Consequently the frequency and the profile of patients with HL-associated AIHA/AITP have not been well defined. Among 1029 patients with HL diagnosed between 1990 and 2010, two cases of AIHA (0.19%) and three of AITP (0.29%) were identified at the presentation of disease. These patients were significantly older, and more frequently had features of advanced disease and non-nodular sclerosing histology, compared to the majority of patients, who did not have autoimmune cytopenias at diagnosis. ABVD combination chemotherapy (doxorubicin, bleomycin, vinblastine, dacarbazine) provided effective control of HL and the autoimmune condition as well. During approximately 6600 person-years of follow-up for the remaining 1024 patients, seven (0.7%) patients developed autoimmune cytopenias (three AITP, three AIHA, one autoimmune pancytopenia) for a 10- and 15-year actuarial incidence of 0.95% and 1.40%, respectively. Their features did not differ compared to the general population of adult HL. In this large series of consecutive, unselected patients, those who presented with autoimmune cytopenias had a particular demographic and disease-related profile. In contrast, patients developing autoimmune cytopenias during follow-up did not appear to differ significantly from those who did not.
authors.affiliation: Department of Hematology, Athens Medical Center, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Dimou
authors.forename: Maria K
authors.initials: MK
authors.lastname: Angelopoulou
authors.forename: Gerassimos A
authors.initials: GA
authors.lastname: Pangalis
authors.forename: Georgios
authors.initials: G
authors.lastname: Georgiou
authors.forename: Christina
authors.initials: C
authors.lastname: Kalpadakis
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Pappi
authors.forename: Olga
authors.initials: O
authors.lastname: Tsopra
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Koutsoukos
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Zografos
authors.forename: George
authors.initials: G
authors.lastname: Boutsikas
authors.forename: Maria
authors.initials: M
authors.lastname: Moschogianni
authors.forename: Ioanna
authors.initials: I
authors.lastname: Vardounioti
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Petevi
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Karali
authors.forename: Alexandros
authors.initials: A
authors.lastname: Kanellopoulos
authors.forename: Themis
authors.initials: T
authors.lastname: Ntalageorgos
authors.forename: Xanthis
authors.initials: X
authors.lastname: Yiakoumis
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Bartzis
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Bitsani
authors.forename: Elias
authors.initials: E
authors.lastname: Pessach
authors.forename: Anna
authors.initials: A
authors.lastname: Efthimiou
authors.forename: Penelope
authors.initials: P
authors.lastname: Korkolopoulou
authors.forename: George
authors.initials: G
authors.lastname: Rassidakis
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Kyrtsonis
authors.forename: Efstratios
authors.initials: E
authors.lastname: Patsouris
authors.forename: John
authors.initials: J
authors.lastname: Meletis
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Panayiotidis
authors.forename: Theodoros P
authors.initials: TP
authors.lastname: Vassilakopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications / Q000276:immunology* / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000627:therapeutic use; D015897:Comorbidity; D003606:Dacarbazine / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006689:Hodgkin Disease / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications / Q000276:immunology* / Q000628:therapy*; D016896:Treatment Outcome; D014747:Vinblastine / Q000627:therapeutic use
chemical_list: D001761:Bleomycin; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin