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A Case of Cold Agglutinin Disease With Transformation to High-Grade Lymphoma During Sutimlimab Treatment

Year: 2025

Type: article

Abstract: Cold agglutinin disease (CAD) is an autoimmune hemolytic anemia characterized by monoclonal immunoglobulin M-mediated cold agglutinins and monoclonal B-cell proliferation. Sutimlimab, a complement C1s inhibitor, alleviates hemolytic anemia in CAD by blocking the classical complement pathway. We report a case of a 67-year-old Japanese woman with CAD who experienced temporal improvement in anemia following sutimlimab treatment. 18F-fluorodeoxyglucose positron-emission tomography/computed tomography and bone marrow biopsy (BMB) revealed histological transformation into aggressive B-cell lymphoma. Subsequent chemotherapy with polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin, and prednisolone resulted in further improvement in anemia. This case highlights the importance of reassessing underlying conditions through BMB in cases where sutimlimab treatment is ineffective.

Source: Cureus

DOI: 10.7759/cureus.87006

Authors: Shota Yamaguchi, Kenki Saito, Keiji Shimada, Naoya Kaneko

Institutions: Nara City Hospital, Nara Prefecture General Medical Center, Nara Medical University, Nerima Hikarigaoka Hospital

Language: English

Topic: Blood groups and transfusion

Subfield: Hematology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4411840931