Autoimmune Hemolytic Anemia and Nodular Lymphocyte-Predominant Hodgkin Lymphoma: A Rare Association. (28th April 2013)

• Record Type: Journal Article
• Authors: Salmeron, Géraldine; Molina, Thierry Jo; Fieschi, Claire; Zagdanski, Anne-Marie; Brice, Pauline; Sibon, David
• Other Names: Damaj G. Academic Editor.; Kyrtsonis M.-C. Academic Editor.; Matsukawa Y. Academic Editor.; Rund D. Academic Editor.
• Is Part Of: Case reports in hematology. Volume 2013(2013)
• Publication Date: 2013-04-28
• Subjects: Hematology -- Periodicals; Hematology -- Case studies -- Periodicals; Blood -- Diseases -- Periodicals; Hematology; Hematologic Diseases; Blood -- Diseases; Hematology; Electronic journals; Periodicals; Case studies; Periodicals; Case Reports; Fulltext; Internet Resources; Periodicals; 616.15
• DOI: 10.1155/2013/567289
• Languages: English
• ISSNs: 2090-6560

Abstract

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.