Combined immune checkpoint inhibitors disrupt T-cell tolerance, leading to the expansion of CD39SP T cells and the onset of autoimmune hemolytic anemia (AIHA). Combined ICPis (blocking antibodies against PD-1, Lag-3, CTLA-4, and IL-10R) promote the expansion of CD39SP, causing an imbalance between Treg and effector T cells. CD39SP cells release proinflammatory cytokines interleukin-17 (IL-17) and interferon-γ (IFN-γ), stimulate B-cell proliferation, and promote the development of AIHA.¹