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Erschienen in: Wiener klinische Wochenschrift 11-12/2014

01.06.2014 | original article

Cold antibody autoimmune hemolytic anemia and lymphoproliferative disorders: a retrospective study of 20 patients including clinical, hematological, and molecular findings

verfasst von: Cathrin Arthold, Cathrin Skrabs, MD, Gerlinde Mitterbauer-Hohendanner, MD, Renate Thalhammer, MD, Ingrid Simonitsch-Klupp, MD, Simon Panzer, MD, Peter Valent, Klaus Lechner, MD, Ulrich Jäger, MD, Christian Sillaber, MD

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 11-12/2014

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Summary

A total of 20 patients with cold antibody hemolytic anemia were evaluated in a retrospective study of them, 15 had a monoclonal gammopathy of unknown significance (MGUS): 14 with MGUS of immunoglobulin M (IgM) subtype and 1 with immunoglobulin G subtype. One patient had smoldering Waldenström’s macroglobulinemia, but four patients had no monoclonal protein and no evidence of lymphoma. However, in three of these patients, we were able to demonstrate a (mono-)clonal rearrangement of their immunoglobulin heavy and/or light chains. Of the 20 patients, 5 had IgHV34 nucleotide sequence indicating that the antibody was directed against the “I” antigen. Two patients exhibited a progressive increase of IgM over time, however without increasing hemolytic activity. Moreover, in two patients with long-term follow-up, we were able to correlate recurrent hemolytic activity with low environmental temperatures. Among four patients treated with rituximab, all four responded to treatment. However, treatment effect was only transient in all of them.
Literatur
1.
Zurück zum Zitat Donath J, Landsteiner K. Über paroxysomale Hämoglobinurie. Munch Med Wochenschr. 1904;51:1590–3. Donath J, Landsteiner K. Über paroxysomale Hämoglobinurie. Munch Med Wochenschr. 1904;51:1590–3.
2.
Zurück zum Zitat Puthenparambil J, Lechner K, Kornek G. Autoimmune hemolytic anemia as a paraneoplastic phenomenon in solid tumors: a critical analysis of 52 cases reported in the literature. Wien Klin Wochenschr. 2010;122(7–8):229–36.PubMedCrossRef Puthenparambil J, Lechner K, Kornek G. Autoimmune hemolytic anemia as a paraneoplastic phenomenon in solid tumors: a critical analysis of 52 cases reported in the literature. Wien Klin Wochenschr. 2010;122(7–8):229–36.PubMedCrossRef
3.
Zurück zum Zitat Sokol RJ, Hewitt S, Stamps BK, Hitchen PA. Autoimmune haemolysis in childhood and adolescence. Acta Haematol. 1984;72(4):245–57.PubMedCrossRef Sokol RJ, Hewitt S, Stamps BK, Hitchen PA. Autoimmune haemolysis in childhood and adolescence. Acta Haematol. 1984;72(4):245–57.PubMedCrossRef
4.
Zurück zum Zitat Dacie SJ. The immune haemolytic anaemias: a century of exciting progress in understanding. Br J Haematol. 2001;114(4):770–85.PubMedCrossRef Dacie SJ. The immune haemolytic anaemias: a century of exciting progress in understanding. Br J Haematol. 2001;114(4):770–85.PubMedCrossRef
5.
Zurück zum Zitat Chandesris MO, Schleinitz N, Ferrera V, Bernit E, Mazodier K, Gayet S, et al. Cold agglutinins, clinical presentation and significance; retrospective analysis of 58 patients. Rev Med Interne. 2004;25(12):856–65.PubMedCrossRef Chandesris MO, Schleinitz N, Ferrera V, Bernit E, Mazodier K, Gayet S, et al. Cold agglutinins, clinical presentation and significance; retrospective analysis of 58 patients. Rev Med Interne. 2004;25(12):856–65.PubMedCrossRef
6.
Zurück zum Zitat Gertz MA. Cold hemolytic syndrome. Hematology Am Soc Hematol Educ Program. 2006:19–23. Gertz MA. Cold hemolytic syndrome. Hematology Am Soc Hematol Educ Program. 2006:19–23.
8.
Zurück zum Zitat Schubothe H. Current problems of chronic cold hemagglutinin disease. Ann N Y Acad Sci. 1965;124(2):484–90.PubMedCrossRef Schubothe H. Current problems of chronic cold hemagglutinin disease. Ann N Y Acad Sci. 1965;124(2):484–90.PubMedCrossRef
9.
Zurück zum Zitat Crisp D, Pruzanski W. B-cell neoplasms with homogeneous cold-reacting antibodies (cold agglutinins). Am J Med. 1982;72(6):915–22.PubMedCrossRef Crisp D, Pruzanski W. B-cell neoplasms with homogeneous cold-reacting antibodies (cold agglutinins). Am J Med. 1982;72(6):915–22.PubMedCrossRef
10.
Zurück zum Zitat Berentsen S, Ulvestad E, Langholm R, Beiske K, Hjorth-Hansen H, Ghanima W, et al. Primary chronic cold agglutinin disease: a population based clinical study of 86 patients. Haematologica. 2006;91(4):460–6.PubMed Berentsen S, Ulvestad E, Langholm R, Beiske K, Hjorth-Hansen H, Ghanima W, et al. Primary chronic cold agglutinin disease: a population based clinical study of 86 patients. Haematologica. 2006;91(4):460–6.PubMed
11.
Zurück zum Zitat Schöllkopf C, Kjeldsen L, Bjerrum OW, Mourits-Andersen HT, Nielsen JL, Christensen BE, et al. Rituximab in chronic cold agglutinin disease: a prospective study of 20 patients. Leuk Lymphoma. 2006;47(2):253–60.PubMedCrossRef Schöllkopf C, Kjeldsen L, Bjerrum OW, Mourits-Andersen HT, Nielsen JL, Christensen BE, et al. Rituximab in chronic cold agglutinin disease: a prospective study of 20 patients. Leuk Lymphoma. 2006;47(2):253–60.PubMedCrossRef
12.
Zurück zum Zitat van Dongen JJ, Langerak AW, Lavender FL, et al. Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: report of the BIOMED-2 Concerted Action BMH4-CT98-3936. Leukemia. 2003;17(12):2257–317.PubMedCrossRef van Dongen JJ, Langerak AW, Lavender FL, et al. Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: report of the BIOMED-2 Concerted Action BMH4-CT98-3936. Leukemia. 2003;17(12):2257–317.PubMedCrossRef
13.
Zurück zum Zitat Stilgenbauer S, Bullinger L, Lichter P, Döhner H, German CLL Study Group (GCLLSG). Genetics of chronic lymphocytic leukemia: genomic aberrations and V(H) gene mutation status in pathogenesis and clinical course. Leukemia. 2002;16(6):993–1007. Stilgenbauer S, Bullinger L, Lichter P, Döhner H, German CLL Study Group (GCLLSG). Genetics of chronic lymphocytic leukemia: genomic aberrations and V(H) gene mutation status in pathogenesis and clinical course. Leukemia. 2002;16(6):993–1007.
14.
Zurück zum Zitat Kyle RA, Benson JT, Larson DR, Therneau TM, Dispenzieri A, Kumar S, et al. Long-term follow-up of IgM monoclonal gammopathy of undetermined significance. Blood. 2003;102(10):3759–64.PubMedCrossRef Kyle RA, Benson JT, Larson DR, Therneau TM, Dispenzieri A, Kumar S, et al. Long-term follow-up of IgM monoclonal gammopathy of undetermined significance. Blood. 2003;102(10):3759–64.PubMedCrossRef
15.
Zurück zum Zitat Kyle RA, Benson JT, Larson DR, Therneau TM, Dispenzieri A, Kumar S, et al. Progression in smoldering Waldenstrom macroglobulinemia: long-term results. Blood. 2012;119(19):4462–6.PubMedCentralPubMedCrossRef Kyle RA, Benson JT, Larson DR, Therneau TM, Dispenzieri A, Kumar S, et al. Progression in smoldering Waldenstrom macroglobulinemia: long-term results. Blood. 2012;119(19):4462–6.PubMedCentralPubMedCrossRef
16.
Zurück zum Zitat Berentsen S, Bø K, Shammas FV, Myking AO, Ulvestad E. Chronic cold agglutinin disease of the “idiopathic” type is a premalignant or low-grade malignant lymphoproliferative disease. APMIS. 1997;105(5):354–62.PubMedCrossRef Berentsen S, Bø K, Shammas FV, Myking AO, Ulvestad E. Chronic cold agglutinin disease of the “idiopathic” type is a premalignant or low-grade malignant lymphoproliferative disease. APMIS. 1997;105(5):354–62.PubMedCrossRef
17.
Zurück zum Zitat Isbister JP, Cooper DA, Blake HM, Biggs JC, Dixon RA, Penny R. Lymphoproliferative disease with IgM lambda monoclonal protein and autoimmune hemolytic anemia. A report of four cases and a review of the literature. Am J Med. 1978;64(3):434–40.PubMedCrossRef Isbister JP, Cooper DA, Blake HM, Biggs JC, Dixon RA, Penny R. Lymphoproliferative disease with IgM lambda monoclonal protein and autoimmune hemolytic anemia. A report of four cases and a review of the literature. Am J Med. 1978;64(3):434–40.PubMedCrossRef
18.
Zurück zum Zitat Crosby WH, Rappaport H. Autoimmune hemolytic anemia. I. Analysis of hematologic observations with particular reference to their prognostic value; a survey of 57 cases. Blood. 1957;12(1):42–55.PubMed Crosby WH, Rappaport H. Autoimmune hemolytic anemia. I. Analysis of hematologic observations with particular reference to their prognostic value; a survey of 57 cases. Blood. 1957;12(1):42–55.PubMed
19.
Zurück zum Zitat Berentsen S, Ulvestad E, Gjertsen BT, Hjorth-Hansen H, Langholm R, Knutsen H, et al. Rituximab for primary chronic cold agglutinin disease: a prospective study of 37 courses of therapy in 27 patients. Blood. 2004;103(8):2925–8.PubMedCrossRef Berentsen S, Ulvestad E, Gjertsen BT, Hjorth-Hansen H, Langholm R, Knutsen H, et al. Rituximab for primary chronic cold agglutinin disease: a prospective study of 37 courses of therapy in 27 patients. Blood. 2004;103(8):2925–8.PubMedCrossRef
20.
Zurück zum Zitat Berentsen S, Randen U, Vågan AM, Hjorth-Hansen H, Vik A, Dalgaard J, et al. High response rate and durable remissions following fludarabine and rituximab combination therapy for chronic cold agglutinin disease. Blood. 2010;116(17):3180–4.PubMedCrossRef Berentsen S, Randen U, Vågan AM, Hjorth-Hansen H, Vik A, Dalgaard J, et al. High response rate and durable remissions following fludarabine and rituximab combination therapy for chronic cold agglutinin disease. Blood. 2010;116(17):3180–4.PubMedCrossRef
21.
Zurück zum Zitat Hauswirth AW, Skrabs C, Schützinger C, Gaiger A, Lechner K, Jäger U. Autoimmune hemolytic anemias, Evans’ syndromes, and pure red cell aplasia in non-Hodgkin lymphomas. Leuk Lymphoma. 2007;48(6):1139–49.PubMedCrossRef Hauswirth AW, Skrabs C, Schützinger C, Gaiger A, Lechner K, Jäger U. Autoimmune hemolytic anemias, Evans’ syndromes, and pure red cell aplasia in non-Hodgkin lymphomas. Leuk Lymphoma. 2007;48(6):1139–49.PubMedCrossRef
Metadaten
Titel
Cold antibody autoimmune hemolytic anemia and lymphoproliferative disorders: a retrospective study of 20 patients including clinical, hematological, and molecular findings
verfasst von
Cathrin Arthold
Cathrin Skrabs, MD
Gerlinde Mitterbauer-Hohendanner, MD
Renate Thalhammer, MD
Ingrid Simonitsch-Klupp, MD
Simon Panzer, MD
Peter Valent
Klaus Lechner, MD
Ulrich Jäger, MD
Christian Sillaber, MD
Publikationsdatum
01.06.2014
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 11-12/2014
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-014-0547-z

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