Melphalan (Alkeran®) Erythrocyte Agglutinin and Hemolytic Anemia

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Abstract
A case of L-phenylalanine mustard (Alkeran) hyperensitivity associated with hemolytic anemia is reported. The patient''s serum caused in vitro agglutination of normal compatible erythrocytes in the presence of the drug but not in its absence. The antibody was shown to be an immunoglobulin agglutinin which did not fix complement. Hemolysis was temporally related to the presence of the serum agglutinin and was influenced by corticosteroid therapy. The literature of other drug induced immunohemolytic anemias is reviewed in relation to these findings.