Description:
<jats:title>Abstract</jats:title><jats:p> <jats:bold>Background and objectives</jats:bold>: Mixed‐type autoimmune hemolytic anemia (AIHA) is a rare complication of chronic lympocytic leukemia (CLL). We report a patient with small lymphocytic lymphoma (phenotypic CLL) who developed symptomatic anemia 3 weeks after her fifth cycle of fludarabine, a T cell immunosuppressant. <jats:bold>Materials and methods</jats:bold>: An antibody screen and panel, direct antiglobulin test, rapid acid eluate, rabbit erythrocyte stroma (RESt) adsorption, and autoadsorption were performed. <jats:bold>Results</jats:bold>: Warm and cold autoantibodies were detected. Prompt treatment with corticosteroids and minimal blood transfusions led to marked improvement. <jats:bold>Conslusion</jats:bold>: Normally, T cells suppress polyclonal lymphocytes that produce autoantibodies. Suppression of T cells in this patient, in addition to the underlying disease process, may explain this mixed‐type AIHA, the first reported case to occur following fludarabine treatment.</jats:p>