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KMID : 0387820230300020091
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Clinical Pediatric Hematology-Oncology
2023 Volume.30 No. 2 p.91 ~ p.94
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Successful Treatment of Autoimmune Hemolytic Anemia with Sirolimus after Allogeneic Hematopoietic Stem Cell Transplantation: A Case Report
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Park Hyun-Jin
Choi Jung-Yoon
Hong Kyung-Taek
Kim Jung-Su
Kang Hyoung-Jin
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Abstract
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Autoimmune hemolytic anemia (AIHA) is a common complication after hematopoietic stem cell transplantation (HSCT). Although post-HSCT AIHA is associated with poor prognosis and is more resistant to treatment than primary AIHA, the standard treat-ment has not yet been determined. We report a case of post-HSCT AIHA, which oc-curred 9 years after unrelated donor bone marrow transplantation for acute bipheno-typic leukemia. Steroid treatment was initially effective but prolonged steroid usage, due to recurrent relapses, caused avascular necrosis. Although rituximab was un-successful in preventing relapses, sirolimus was effective in allowing the discontinua-tion of steroid treatment and sustaining transfusion-free status. Sirolimus, previously reported to be effective in pediatric post-HSCT AIHA and AIHA after solid organ transplantation, may be effective in adult post-HSCT AIHA as well.
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KEYWORD
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Autoimmune hemolytic anemia, Hematopoietic stem cell transplantation, Sirolimus
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