Vinblastine-loaded platelets for autoimmune hemolytic anemia

Treatment of autoimmune hemolytic anemia with corticosteroids, splenectomy, immune suppression, and plasma exchange, serially or in combination, often yields partial or short remissions. We describe a patient in whom refractory autoimmune hemolytic anemia was moderated by selective impairment of the mononuclear-phagocyte system by means of infusion of vinblastine-loaded platelets. The success of this approach, initially proposed for treatment of immune thrombocytopenic purpura, suggests that erythrocytes and platelets share a common site of immune destruction and that the rate of this destruction is determined by the phagocyte.