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Letters to the Editor
play a role in the inflammatory milieu and bone marrow dysregulation of AIHA. An interesting hypothesis is that an autoimmune attack may also occur against bone mar- row precursors, resulting in peripheral reticulocytopenia and accounting for the severity of AIHA.6,15 In this con- text, therapy with recombinant EPO may interrupt the vicious circle, by priming the reticulocyte compensation, sustaining erythropoiesis and leaving time for the resolu- tion of the autoimmune flare avoiding excessive immune-suppression.
Bruno Fattizzo,1 Marc Michel,2,3 Anna Zaninoni,1
Juri A. Giannotta,1 Stephanie Guillet,2,3 Henrik Frederiksen,4 Josephine M.I. Vos,5 Francesca R. Mauro,6 Bernd Jilma,7 Andrea Patriarca,8 Francesco Zaja,9 Anita Hill,10
Sigbjørn Berentsen11 and Wilma Barcellini1
1Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano and University of Milan, Milan, Italy; 2Department of Internal Medecine, Henri Mondor University Hospital, Assistance Publique Hôpitaux de Paris, Creteil, France; 3Internal Medecine, National Reference Center for Adult Immune Cytopenias, Henri Mondor University Hospital, Université Paris- Est Créteil, France; 4Department of Haematology, Odense University Hospital, Odense, Denmark; 5Amsterdam UMC, Location AMC, Department of Hematology, Amsterdam,
the Netherlands; 6Hematology, Department of Translational
and Precision Medicine, Sapienza University, Rome, Italy; 7Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria; 8UO Ematologia, AOU Maggiore della Carità, Novara, Italy; 9S.C. Ematologia, Azienda Sanitaria Universitaria Integrata, Trieste, ITA; 10Hematology, Leeds Teaching Hospitals, Leeds, UK and 11Department of Research and Innovation, Haugesund Hospital, Haugesund, Norway
Correspondence:
WILMA BARCELLINI - wilma.barcellini@policlinico.mi.it
doi:10.3324/haematol.2020.250522
Disclosures: all authors declare that they have no financial nor personal relationships with other people or organisations that could inappropriately influence (bias) their work.
Contributions: B F and W B designed the study, followed patients, collected and analyzed data, wrote the paper and revised the paper for important intellectual content. MM, JG, SG, HF, JMIV, FRM, BJ, AP, FZ, AH, and SB followed patients, collected data, and revised the paper for important intellectual content. AZ performed cytokines studies and revised the paper for important intellectual content.
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