A Case of Autoimmune Haemolytic Anaemia After Allogeneic Stem Cell Transplantation in Adult Patient: A Refractory and High Mortality Outcome

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Salfarina Iberahim
Mohd Nazri Hassan
Wan Zuhairah W Embong
Zefarina Zulkafli
Wan Suriana Wan Abd Rahman
Noor Haslina Mohd Noor
Azlan Husin
Abu Dzarr Abdullah

Abstract

Autoimmune haemolytic anaemia (AIHA) is a complication arising from allogeneic haemopoietic stem cell transplantation (AHSCT), and it poses a significant challenge in patient management with poor outcome. We present the case of a 32-year-old Malay woman with chronic myeloid leukaemia who, after treatment failure with a tyrosine kinase inhibitor, was referred for AHSCT with HLA-matched peripheral blood stem cells donated by her younger brother. She suffered acute graft-versus-host disease and cytomegalovirus infection within three months post-transplant, followed by AIHA. She did not respond to multiple treatment modalities and had to be frequently admitted to hospital due to symptomatic anaemia which requiring frequent blood transfusion. Here, we highlight an AIHA case in post-AHSCT as a refractory disease due to resistance to standard treatment. This is a condition that requires close monitoring and care because it carries a high risk of morbidity and mortality for the patient, who unfortunately succumbed to her disease.

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Case Report