59 patients with lymphoma have been studied prospectively at the Oncology Department of the City Hospital in Pordenone to assess the presence of hyperhemolysis and antierythrocyte autoimmunization with its variability during the therapy. 24 patients had Hodgkin lymphoma, 13 non-Hodgkin lymphoma, 10 chronic lymphocytic leukemia and 12 other lymphocytic disease (Waldenstrom macroglobulinemia, myeloma, mycosis fungoides). Every patient was first controlled at the beginning of the study; 20 patients were also studied after 1.2 months of therapy and 9 were sutied three or more times during the course of the illness. The laboratory tests included: a) direct Coombs test with commercial broad spectrum and specific (anti-complement, anti-C3d, anti-C3 and anti-C4) antiglobulin sera, b) indirect Coombs test, c) titre of cold agglutinins and d) red cells count, Hb and indirect bilirubin determination with reticulocytes and serum haptoglobin determination. Only three patients showed signs of hyperhemolysis (5%). 11 patients (18.6%) were found to have a positive direct Coombs test at the first control. The positivity was due to the presence of C3d fragment on the red cells. 2 out of the 11 patients had also IgG auto antibody on the red cells and 2 had high cold agglutinins titre in the serum with anti-I(F) specificity in one and anti-i in the other. No correlation was found between the immuno-chemical picture and the occurrence of hyperhemolysis or the histopathology. No modification of the immunochemical findings was found at the controls performed during the therapy except in one patient with chronic lymphocytic leukemia where the IgG autoantibody disappeared during the therapy with corticosteroids leaving the C3d on the red cells. We conclude that the presence of C3d on the red cells is highly frequent in patients with lymphoma but it doesn't indicate an increased rate of red cells destruction.
|Translated title of the contribution||Autoimmune hemolytic disease and malignant lymphoma|
|Number of pages||10|
|Journal||Trasfusione del Sangue|
|Publication status||Published - 1979|
ASJC Scopus subject areas
- Immunology and Allergy