Korean J Hematol 2005; 40(2):
Published online June 30, 2005
https://doi.org/10.5045/kjh.2005.40.2.116
© The Korean Society of Hematology
문승환, 정석희, 정동식, 이창재, 서봉근, 김성현, 권혁찬, 김재석, 김효진
동아대학교 의과대학 내과학교실
Waldenstrom macroglobulinemia, which is characterized by elevation of serum monoclonal IgM paraprotein, has recently been responsible for the treatment of purine analogues. Fludarabine, one of purine analogues, has been associated with autoimmune hemolytic anemia in patient with chronic lymphocytic leukemia. However, autoimmune hemolytic anemia after fludarabine treatment for Waldenstrom macroglobulinemia has not been reported. We experienced a case of autoimmune hemolytic anemia after fludarabine treatment for Waldenstrom macroglobulinemia. In this case, hemolytic anemia with positive direct Coombs' test occurred at 20 months after the first administration of fludarabine, relapsed at 5 days after re-administration. This anemia responded to steroid therapy. Autoimmune hemolytic anemia associated with fludarabine therapy can be severe and fatal, especially if a patient is re-treated with this drug after a previous episode of hemolytic anemia.
Keywords Autoimmune hemolytic anemia, Waldenstrom macroglobulinemia, Fludarabine
Korean J Hematol 2005; 40(2): 116-119
Published online June 30, 2005 https://doi.org/10.5045/kjh.2005.40.2.116
Copyright © The Korean Society of Hematology.
문승환, 정석희, 정동식, 이창재, 서봉근, 김성현, 권혁찬, 김재석, 김효진
동아대학교 의과대학 내과학교실
Seung Hwan Moon, Seuk Hee Chung, Dong Sik Jung, Chang Jae Lee, Bong Gun Seo, Sung Hyun Kim, Hyuk Chan Kwon, Jae Seok Kim, Hyo Jin Kim
Department of Internal Medicine, Dong, A University College of Medicine, Busan, Korea
Waldenstrom macroglobulinemia, which is characterized by elevation of serum monoclonal IgM paraprotein, has recently been responsible for the treatment of purine analogues. Fludarabine, one of purine analogues, has been associated with autoimmune hemolytic anemia in patient with chronic lymphocytic leukemia. However, autoimmune hemolytic anemia after fludarabine treatment for Waldenstrom macroglobulinemia has not been reported. We experienced a case of autoimmune hemolytic anemia after fludarabine treatment for Waldenstrom macroglobulinemia. In this case, hemolytic anemia with positive direct Coombs' test occurred at 20 months after the first administration of fludarabine, relapsed at 5 days after re-administration. This anemia responded to steroid therapy. Autoimmune hemolytic anemia associated with fludarabine therapy can be severe and fatal, especially if a patient is re-treated with this drug after a previous episode of hemolytic anemia.
Keywords: Autoimmune hemolytic anemia, Waldenstrom macroglobulinemia, Fludarabine
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