Supplementary Material for: Warm autoimmune hemolytic anemia as first presentation of chronic myeloid leukemia: A case report

Introduction Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm marked by the presence of the Philadelphia chromosome and uncontrolled granulocyte production. While autoimmune hemolytic anemia (AIHA) is commonly associated with lymphoproliferative disorders like CLL, its occurrence in CML is rare, with limited cases documented. Here, we report a case of concurrent chronic phase CML and AIHA. Case presentation: A 34-year-old female patient with warm autoimmune hemolytic anemia (AIHA) as a first presentation of chronic myeloid leukemia (CML). Diagnostic workup including the peripheral smear showed evidence of hemolysis together with high LDH and positive DAT in addition to positive Philadelphia chromosome which is diagnostic for CML. Steroid therapy successfully managed the AIHA, and the patient’s hemoglobin levels normalized, allowing for tapering and discontinuation of steroids. Conclusion: while AIHA is a rare cause of anemia in CML, it should be considered during the evaluation of anemia, particularly following a relapse of CML.

慢性髓性白血病（CML）是一种以费城染色体存在和未受控制的粒细胞生成为特征的髓增殖性肿瘤。尽管自身免疫性溶血性贫血（AIHA）常与淋巴细胞增殖性疾病如慢性淋巴细胞白血病（CLL）相关联，但其在CML中的发生极为罕见，仅有少数案例被记录。在本研究中，我们报道了一例慢性相CML和AIHA同时发生的病例。病例介绍：一位34岁女性患者，以温性自身免疫性溶血性贫血（AIHA）作为慢性髓性白血病（CML）的首发症状。诊断检查包括外周血涂片，显示出溶血证据，同时LDH升高，DAT阳性，以及费城染色体的阳性，后两者均为CML的诊断指标。通过类固醇治疗成功控制了AIHA，患者的血红蛋白水平恢复正常，从而允许减少和停用类固醇。结论：尽管AIHA是CML中贫血的罕见原因，但在评估贫血时，尤其是在CML复发后，应予以考虑。