Autoimmune Hemolytic Anemia Occurring One Year Before Acute Leukemic Manifestation of Lymphoma with a Chronic Lymphocytic Leukemia Immunophenotype

We herein report a case of the leukemic phase of chronic lymphocytic leukemia (CLL)-type lymphoma that abruptly developed 12 months after the initial diagnosis of autoimmune hemolytic anemia (AIHA), in which retrospective immunohistochemistry and next-generation sequencing (NGS) revealed that (1) lymphoma with a CLL-type immunophenotype underlay the development of secondary AIHA, (2) complete loss of TP53 function by double-hit TP53 abnormalities (TP53 deletion and mutation) was secondarily acquired, and (3) complete loss of TP53 function could have contributed to clinical manifestation of transformed lymphoma. Immunohistochemistry for LEF1 and an NGS analysis may help physicians precisely diagnose CLL-type lymphoproliferation-associated AIHA.