Positive Coombs test in Hodgkin's disease: Significance and implications

Abstract

To clarify the clinicopathologic characteristics of Coomb's positivity in Hodgkin's disease, the records of 71 cases were reviewed. The direct Coombs test was positive in 7. Mean age of the 7 was 22 yr (range 11-33). All were males. All had extensive disease (pathologic stage III or IV) and 6 had systemic (B) symptoms. Four had mixed cellularity; 3 had nodular sclerosis. The positive Coombs test was detected at original diagnosis in 3 and at time of relapse in 4. Although all were anemic, only 3 had evidence of overt hemolysis. The antibody responsible for Coombs positivity was characterized in 3 and fulfilled the criteria for IgG anti-I(t). The presence of a positive direct Coombs test in the patient with Hodgkin's disease suggests active and advanced disease. The presence of IgG anti-I(t) may represent a unique antibody in the Coombs-positive hemolytic anemia assocated with Hodgkin's disease.