Clinical features, treatment and outcomes of adult warm autoimmune hemolytic anemia: A multicenter retrospective cohort study
Abstract
Background Warm autoimmune hemolytic anemia (wAIHA) is a rare autoimmune disease characterized by hemolysis and anemia due to autoantibodies against erythrocytes, and few studies describe its clinical characteristics in China. Objectives To describe the clinical features of adult patients with wAIHA, and assess treatment patterns, response and overall survival. Design We performed a multicenter retrospective analysis of adult patients hospitalized with wAIHA between 01 January 2014 and 31 March 2024 in three hospitals in Shanghai, China. Methods The clinical, therapeutic and survival data of patients with wAIHA were analyzed. Overall survival (OS) was estimated using the Kaplan-Meier method, and Cox regression analysis was used to identify independent prognostic factors. Results A total of 202 patients were included, 51.5% with primary and 48.5% with secondary wAIHA. The median ages at diagnosis were 59.0 and 56.0 years, respectively. Of the primary patients 94.2% received corticosteroids as first-line therapy and 94.6% of them achieved a complete or partial response. Among 56 responders with available relapse information, 53.6% experienced at least one relapse. There were 64 patients who need further treatment while only 29.7% received second-line therapy. The median duration of corticosteroids use was 20.0 months and the most frequent corticosteroid-related complications were infections and diabetes. The survival rate at 1-year after diagnosis were 91.1% and 80.5% respectively in patients with primary and secondary wAIHA. Age ≥ 60 years, the presence of ≥ 2 comorbidities and infectious complications were associated with overall survival ( P =0.004, 0.019 and < 0.001 respectively) in primary wAIHA. Conclusion In our study, wAIHA is characterized by a relapsing clinical course and under-utilization of second-line treatment, highlighting significant unmet medical needs in the management of patients with wAIHA, and suggesting a need for improved clinical awareness.
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BibTeX
@article{yue2026clinical,
title = {{Clinical features, treatment and outcomes of adult warm autoimmune hemolytic anemia: A multicenter retrospective cohort study}},
author = {Wenru Yue and Jie Shao and Yihan Liu and Meng Shu and Sijia Dong and Xiaoqin Wang and Ting Wu},
journal = {Therapeutic Advances in Hematology},
year = {2026},
month = oct,
doi = {10.1177/20406207261491919},
url = {https://doi.org/10.1177/20406207261491919},
note = {CC BY},
}
RIS
TY - JOUR
TI - Clinical features, treatment and outcomes of adult warm autoimmune hemolytic anemia: A multicenter retrospective cohort study
AU - Wenru Yue
AU - Jie Shao
AU - Yihan Liu
AU - Meng Shu
AU - Sijia Dong
AU - Xiaoqin Wang
AU - Ting Wu
PY - 2026
DA - 2026/10/23
JO - Therapeutic Advances in Hematology
DO - 10.1177/20406207261491919
UR - https://doi.org/10.1177/20406207261491919
AB - Background Warm autoimmune hemolytic anemia (wAIHA) is a rare autoimmune disease characterized by hemolysis and anemia due to autoantibodies against erythrocytes, and few studies describe its clinical characteristics in China. Objectives To describe the clinical features of adult patients with wAIHA, and assess treatment patterns, response and overall survival. Design We performed a multicenter retrospective analysis of adult patients hospitalized with wAIHA between 01 January 2014 and 31 March 2024 in three hospitals in Shanghai, China. Methods The clinical, therapeutic and survival data of patients with wAIHA were analyzed. Overall survival (OS) was estimated using the Kaplan-Meier method, and Cox regression analysis was used to identify independent prognostic factors. Results A total of 202 patients were included, 51.5% with primary and 48.5% with secondary wAIHA. The median ages at diagnosis were 59.0 and 56.0 years, respectively. Of the primary patients 94.2% received corticosteroids as first-line therapy and 94.6% of them achieved a complete or partial response. Among 56 responders with available relapse information, 53.6% experienced at least one relapse. There were 64 patients who need further treatment while only 29.7% received second-line therapy. The median duration of corticosteroids use was 20.0 months and the most frequent corticosteroid-related complications were infections and diabetes. The survival rate at 1-year after diagnosis were 91.1% and 80.5% respectively in patients with primary and secondary wAIHA. Age ≥ 60 years, the presence of ≥ 2 comorbidities and infectious complications were associated with overall survival ( P =0.004, 0.019 and < 0.001 respectively) in primary wAIHA. Conclusion In our study, wAIHA is characterized by a relapsing clinical course and under-utilization of second-line treatment, highlighting significant unmet medical needs in the management of patients with wAIHA, and suggesting a need for improved clinical awareness.
SN - 2040-6215
SN - 2040-6207
ER -