Safety and Efficacy of Red Blood Cell Transfusion to Patients with Warm-type Autoimmune Hemolytic Anemia : Clinical Studies at Showa University Fujigaoka Hospital

Abstract

Red blood cell (RBC) transfusion to patients with autoimmune hemolytic anemia (AIHA) is usually avoided due to the likelihood of destruction of transfused RBCs, but this has not been thoroughly investigated in a clinical setting. In this study, we evaluated the efficacy and safety of 24 RBC transfusions given to eight warm-type AIHA patients on nine occasions. AIHA patients with severe hemolysis and an enhanced but insufficient compensatory erythroid response, or with mild to moderate hemolysis and an impaired reticulocyte response, received RBC transfusions. ABO- and Rhmatched RBCs, which were incompatible according to standard compatibility tests, were given on all but one occasion. In all cases, RBC transfusion ameliorated anemia and anemia-related symptoms and maintained the hemoglobin level without aggravating hemolysis. Acute and delayed transfusion reactions were not observed except on one occasion when a delayed hemolytic reaction was suspected. In conclusion, this study clearly demonstrates that RBC transfusion to AIHA patients is generally safe and effective and justifies its use when judged necessary.