Contributions
Abstract: PB1540
Type: Publication Only
Session title: Enzymopathies, membranopathies and other anemias
Background
Auto immune Heamolytic anemia (AIHA) is a widely used title for a variety of anemia types which are mostly diagnosed by exclusion and comprises a lot of symptoms and signs with a myriad of complications. No age is immune with majority being middle-aged with a significant female predominance over male patients. It could be primary or secondary to many factors but mostly other immune disorders. The treatment may include a watch and wait strategy with regular tonics or the major used line corticosteroids and if the patient fails this immunosuppressive drugs might be added or replace corticosteroids with the increased use of monoclonal antibodies especially rituximab and splenectomy still remains an option for resistant cases with certain types of chemotherapeutic agents. The burden of such medications and their associated toxicities affect the patient adherence to therapy itself and follow up dates which requires meticulous and tailored treatment choices for each patient to decrease disease complications and treatment related adverse events and ensure the patient compliance.
Aims
The Aim of this study is to outline the Demographic characters of Egyptian AIHA patients on regular follow up at an adult academic hematology center in Egypt and the characters of their disease
Methods
This is a descriptive study regarding Adult (above the age of18) AIHA patients on follow up with the clinical hematology unit Oncology center Mansoura University, Dakahlia, Egypt who had recorded follow up visits on our System in the period between 2005 and 2021 regarding their age at diagnosis, sex, baseline criteria, presence of crisis or not method of diagnosis and their follow up regimen.
Results
By reviewing the data on our system over the period of 1-1-2005 and 1-1-2021 we found that we have 228 AIHA anemia patients with 25 males (10.8 %) and 203 females (89.2 %) , The average age at diagnosis at our center was 45 years with the range of 16 – 72 years, The median follow up of our patients was 61 months (180 – 6).All patients with follow up under 6 months were excluded from final analysis. 77.9 % of our patients were primary AIHA while the remaining 22.1% were secondary from which 41.6% were secondary to Viral hepatitis, 16.6% to both of Myelodysplastic syndrome and Systemic lupus erythrmatosis and 8.3% to pregnancy, rheumatoid arthritis and Antiphospholipid syndrome .The average hemoglobin at diagnosis was 7 gm/dl with the range (3 – 12), average White blood cell count was 8 x103/ ml (3 - 67) and platelets average was 205 x103/ ml (5 - 387) . 15.2% of our patients had immune thrombocytopenia and were considered to be having Evan’s syndrome while the other 84.8 had normal platelets count. As regard direct coomb’s test 91.5 % were positive while the remaining 8.5 % were negative while the indirect coomb’s test was positive in 71.2 % and negative in 28.2 %. 75% of our patients required packed red blood cells transfusion during their course of the disease while the rest were not transfused.
Conclusion
Patients with AIHA need more care and psychological support with increasing the awarence regarding their disease characters and complications with an increased need for further progress in the treatments avaibale for them to ensure longer and more stable remissions
Keyword(s): Hemolytic anemia
Abstract: PB1540
Type: Publication Only
Session title: Enzymopathies, membranopathies and other anemias
Background
Auto immune Heamolytic anemia (AIHA) is a widely used title for a variety of anemia types which are mostly diagnosed by exclusion and comprises a lot of symptoms and signs with a myriad of complications. No age is immune with majority being middle-aged with a significant female predominance over male patients. It could be primary or secondary to many factors but mostly other immune disorders. The treatment may include a watch and wait strategy with regular tonics or the major used line corticosteroids and if the patient fails this immunosuppressive drugs might be added or replace corticosteroids with the increased use of monoclonal antibodies especially rituximab and splenectomy still remains an option for resistant cases with certain types of chemotherapeutic agents. The burden of such medications and their associated toxicities affect the patient adherence to therapy itself and follow up dates which requires meticulous and tailored treatment choices for each patient to decrease disease complications and treatment related adverse events and ensure the patient compliance.
Aims
The Aim of this study is to outline the Demographic characters of Egyptian AIHA patients on regular follow up at an adult academic hematology center in Egypt and the characters of their disease
Methods
This is a descriptive study regarding Adult (above the age of18) AIHA patients on follow up with the clinical hematology unit Oncology center Mansoura University, Dakahlia, Egypt who had recorded follow up visits on our System in the period between 2005 and 2021 regarding their age at diagnosis, sex, baseline criteria, presence of crisis or not method of diagnosis and their follow up regimen.
Results
By reviewing the data on our system over the period of 1-1-2005 and 1-1-2021 we found that we have 228 AIHA anemia patients with 25 males (10.8 %) and 203 females (89.2 %) , The average age at diagnosis at our center was 45 years with the range of 16 – 72 years, The median follow up of our patients was 61 months (180 – 6).All patients with follow up under 6 months were excluded from final analysis. 77.9 % of our patients were primary AIHA while the remaining 22.1% were secondary from which 41.6% were secondary to Viral hepatitis, 16.6% to both of Myelodysplastic syndrome and Systemic lupus erythrmatosis and 8.3% to pregnancy, rheumatoid arthritis and Antiphospholipid syndrome .The average hemoglobin at diagnosis was 7 gm/dl with the range (3 – 12), average White blood cell count was 8 x103/ ml (3 - 67) and platelets average was 205 x103/ ml (5 - 387) . 15.2% of our patients had immune thrombocytopenia and were considered to be having Evan’s syndrome while the other 84.8 had normal platelets count. As regard direct coomb’s test 91.5 % were positive while the remaining 8.5 % were negative while the indirect coomb’s test was positive in 71.2 % and negative in 28.2 %. 75% of our patients required packed red blood cells transfusion during their course of the disease while the rest were not transfused.
Conclusion
Patients with AIHA need more care and psychological support with increasing the awarence regarding their disease characters and complications with an increased need for further progress in the treatments avaibale for them to ensure longer and more stable remissions
Keyword(s): Hemolytic anemia