title: Autoimmune hemolytic anemia and nodular lymphocyte-predominant hodgkin lymphoma: a rare association.
abstract: Autoimmune hemolytic anemia (AIHA) has been associated with chronic lymphocytic leukemia, non-Hodgkin lymphoma, and classical Hodgkin lymphoma, but to the best of our knowledge, the association of AIHA and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) has not been reported previously. A 20-year-old woman presented with conjunctival jaundice, fever, asthenia, and hemoglobin 9.2 g/dL revealing IgG-mediated warm antibody AIHA. Computed tomography (CT) scan and positron-emission tomography (PET) scan showed mediastinal and axillary lymph nodes with increased [(18)F]-fluorodeoxyglucose uptake. A mediastinal lymph node was biopsied during mediastinoscopy, and NLPHL was diagnosed by an expert hematopathologist. The hemoglobin level declined to 4.6 g/dL. The treatment consisted of four 28-day cycles of R-ABVD (rituximab 375 mg/m(2) IV, adriamycin 25 mg/m(2) IV, bleomycin 10 mg/m(2) IV, vinblastine 6 mg/m(2) IV, and dacarbazine 375 mg/m(2) IV, each on days 1 and 15). Prednisone was progressively tapered over 10 weeks. After the first chemotherapy cycle, the hemoglobin level rose to 12 g/dL. After the four cycles, PET and CT scans showed complete remission (CR). At the last followup (4 years), AIHA and NLPHL were in sustained CR.
authors.affiliation: Department of Hematology, Hôpital Universitaire Necker-Enfants Malades and Assistance Publique-Hôpitaux de Paris (AP-HP), 149 Rue de Sèvres, 75015 Paris, France.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Salmeron
authors.forename: Thierry Jo
authors.initials: TJ
authors.lastname: Molina
authors.forename: Claire
authors.initials: C
authors.lastname: Fieschi
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Zagdanski
authors.forename: Pauline
authors.initials: P
authors.lastname: Brice
authors.forename: David
authors.initials: D
authors.lastname: Sibon