Autoimmune hemolytic anemia in a patient with acute myelocytic leukemia.

Autoimmune hemolytic anemia (AIHA) has been described in patients with lymphoid neoplasm with an etiologic relationship between the emergence of autoantibodies and lymphocyte dysfunction. Autoimmune disorders are less to develop in patients with other neoplasm like chronic myeloid leukemia, myelodysplastic syndrome or acute myeloid leukemia. Few reports have been documented the development of immune hemolytic anemia in patients with acute myeloid leukemia. We herein, present the case of de novo acute myelomonocytic leukemia associated with autoimmune hemolytic anemia. The patient has no previous medical history of anemia and Hb level at presentation was normal. She received chemotherapy containing Adriamycin plus Cytarabine. She showed marked improvement of anemia after steroid therapy with subsidence of all the clinical and laboratory manifestations of hemolysis when the patient went into remission. AIHA should be considered as one cause of anemia in de novo AML patients, and blood transfusions should be given carefully in such cases to avoid harmful hemolysis.