Evaluation of patients diagnosed with autoimmune hemolytic anemia in terms of etiology and treatment

This study aimed to evaluate the etiological factors, clinical and laboratory characteristics, and treatment responses of patients diagnosed with autoimmune hemolytic anemia (AIHA)at Eskişehir Osmangazi University Faculty of Medicine, Department of Internal Medicine. In this retrospective study, data of 91 patients diagnosed with AIHA between January 1, 2017, and January 1, 2025, were analyzed. Demographic features,serological subtypes, comorbidities, laboratory values, treatment approaches, and clinical outcomes were assessed using hospital records. Of the patients, 63.7% were female, with a median age of 57.3±18.5 years. The distribution of serological subtypes was: warm-type AIHA 46.2%, cold agglutinin disease (CAD) 17.6%, and mixed-type AIHA 36.3%. Secondary AIHA was present in 62.6% of patients, with the most common causes being lymphomas (13.2%), systemic lupus erythematosus (11%), and chronic lymphocytic leukemia (11%). The relapse rate was 19.8%, most frequently observed in mixed-type AIHA. Thromboembolic events occurred in 11% of patients, especially in older individuals. Among patients with primary AIHA, 61.8% received corticosteroids as first-line therapy, with a complete response achieved in 82.4%. Rituximab was administered as second-line therapy in 5 patients, yielding a 60% response rate. AIHA is a heterogeneous disorder in which identifying secondary causes and serological subtypes plays a critical role in diagnosis and treatment. While warm-type AIHA is the most common form, mixed-type cases tend to be more resistant to treatment. Effective therapy and close monitoring are essential in reducing relapse and thromboembolic complications.Key Words: Autoimmune hemolytic anemia, warm AIHA, cold agglutinin disease,treatment response, thrombosis