Case Report of an ABO-Matched Post-Hematopoietic Stem Cell Transplant-Associated Autoimmune Hemolytic Anemia: A Diagnostic and Therapeutic Challenge
Bibliographic record
Abstract
• Autoimmune hemolytic anemia (AIHA) is a rare complication of ABO-matched hematopoietic stem cell transplantation (HSCT). • Chronic graft versus host disease, unrelated and mismatched donors, and lymphocyte depletion in the peri-HSCT period are risk factors for post-HSCT AIHA. • Post-HSCT AIHA is diagnosed by a positive hemolysis laboratory work-up and positive direct antiglobulin testing with usually a pan-reactive antibody in indirect antiglobulin testing. • Post-HSCT AIHA is generally refractory to treatment but combination therapies with steroids, rituximab, intravenous immunoglobulins, and other immunomodulators represent a promising avenue to maximize the likelihood of transfusion independence. Autoimmune hemolytic anemia (AIHA) is a rare complication of ABO-matched hematopoietic stem cell transplantation (HSCT). Post-HSCT AIHA is diagnosed by a positive hemolysis laboratory work-up and positive direct antiglobulin testing with usually a pan-reactive antibody in indirect antiglobulin testing. In this case report, we describe the diagnosis of post-HSCT AIHA in a 62-year-old male patient and its management with combined immunosuppressive therapy with steroids, rituximab, and intravenous immunoglobulin to achieve transfusion independence and disease remission. Post-HSCT AIHA is generally refractory to treatment but this case highlights the role of combination immunosuppressive therapies to maximize the likelihood of transfusion independence.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".