Hemolytic Anemia Associated with Malignant Diseases

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Abstract
Hodgkin''s disease, chronic lymphatic leukemia, reticuloendotheliosis, metastatic carcinomato-sis, sarcoma of the spleen, myelogenous leukemia, lympho-sarcoma, giant follicular lymphoblastoma and Boeck''s sarcoid are occasionally complicated by symptomatic hemolytic anemia. The blood picture and bone marrow in such cases may reflect the changes of both diseases. Spherocytosis and diminution in the resistance of the erythrocytes to hemoly-sis by hypotonic salt soln. occur in about 50% of the cases. The splenic pathology is variable. In some cases "arterial" or active hyperemia is present; in others the specific changes of the underlying disease (e.g., Hodgkin''s disease) are observed; in certain "nonspecific" alterations, such as reticulo-endothelial hyperplasia, erythrophagocytosis and myeloid metaplasia are seen. The reason for this variation is not clear; it is not dependent on any of the hematologic findings. The unpredictable effect of, and indications for, various forms of therapy is discussed. The occurrence of spontaneous remissions is pointed out. The clinical summaries of 10 cases illustrating the clinical and hematologic findings and response to treatment are given.

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