Hemolytic anemia in a quaternary care hospital

A retrospective cohort analysis from 2020 to 2023

Abstract

Introduction: autoimmune hemolytic anemia (AIHA) is characterized by immune-mediated erythrocyte destruction. There is scant clinical evidence in Colombia on the outcomes and demographic characteristics of patients with this condition.

Objective: to characterize the clinical outcomes of adult patients with AIHA treated at a quaternary care hospital in Bogotá, Colombia.

Method: this was a descriptive retrospective cohort study of patients over the age of 18 with AIHA treated between June 2020 and December 2023. Those with other causes of hemolytic anemia and patients whose initial diagnosis was not conclusive were excluded.

Results: we analyzed data from 30 patients with a median age of 50.5 years; 60% were females. All received glucocorticoids as first-line treatment, followed by azathioprine in 83.3% (n=25) and rituximab plus glucocorticoids in 10% (n=3). A total of 16.7% (n=5) relapsed after the initial treatment. After 180 days of follow-up, 96% (n=29) had reached some degree of response: 36.7% achieved a complete response and 60% a partial response. Only 3.3% (n=1) were refractory to three lines of treatment.

Conclusion: this cohort of patients with AIHA responded favorably to initial treatment with glucocorticoids. The low percentage of patients who were refractory to multiple treatment lines suggests that the treatment plans used can effectively control the disease in this population. These findings underscore the importance of continued research to optimize care.