Figure 1.
Treatment algorithms for autoimmune cytopenias in lymphoma. (A) wAIHA. Supportive care: red blood cell transfusions, if hemoglobin level is <8 mg/dL and/or there is symptomatic anemia. Lower hemoglobin levels may be tolerated in well-adapted and/or young adults; higher hemoglobin levels are needed in cases of additional heart diseases or symptomatic anemia in elderly patients. Observe serum ferritin levels to avoid iron overload. Start iron chelation therapy if necessary, add folic acid, osteoporosis inhibitor, and thrombosis prophylaxis. (B) PRCA. Supportive care: as described in panel A, except that folic acid or osteoporosis treatments or thrombosis prophylaxis are not used. (C) CAD. Supportive care: as in panel A, except that folic acid or osteoporosis treatment or thrombosis prophylaxis are not used. (D) ITP. Supportive care: platelet transfusions only for clinically significant bleeding or with surgical intervention. (E) AIG. Supportive care: consider granulocyte transfusions to treat severe sepsis. Detailed regimens are given in Table 1.