ACUTE HEMOLYTIC ANEMIA ASSOCIATED WITH ADMINISTRATION OF ALKYLATING AGENTS - REPORT OF 2 CASES DUE TO CYCLOPHOSPHAMIDE AND REVIEW OF LITERATURE

In a woman with multiple myeloma and a man with Hodgkin''s disease acute hemolytic anemia was related to therapy with cyclophosphamide. Hemolysis abated when this drug was discontinued but recurred promptly when oral cyclophosphamide was given in small doses 6 months later. The literature fails to reveal other reports of association of acute hemolytic anemia with cyclophosphamide, but 12 other cases of acute hemolytic episodes associated with alkylating agents are reviewed. The mechanism of hemolysis due to these drugs is obscure; some observers have felt that this form of therapy or irradiation serves as a trigger to upset some intricate balance in patients with immunoproliferative disorders, but the possibility of drug hypersensitiv-ity reactions has not been excluded.