Autoimmune Hemolytic Anemia After Cord Blood Transplantation: A Retrospective Single-Center Experience

OBJECTIVE: To describe the incidence, possible risk factors, and treatment options of autoimmune hemolytic anemia (AIHA) occurring after cord blood transplantation (CBT). METHODS: We retrospectively analyzed the patients who underwent CBT at Peking University First Hospital between January 2004 and July 2022. RESULTS: We totally identified thirty-six patients who received CBT. Median age was 27.5 years (range, 1.6–52). With a median 6 (range 0.6–10.0) years survivor follow-up, six patients developed AIHA (2 Evans syndrome included) at a median of 168 (range, 122–264) days post-CBT for 8% cumulative incidence density 3 years. Its mortality was 50% and mainly associated with concomitant infections (CMV reactivation rate nearly 100%). The possible risk factors for developing AIHA are CMV reactivation, GvHD and HLA mismatch. CONCLUSION: AIHA is a clinically significant common complication in recipients post-CBT. Corticosteroids combined with intravenous immunoglobulin (IvIg) is recommended for the treatment of warm antibody AIHA after CBT.