Confounding Case of Hemolysis in a Patient with Acute Leukemia/Commentary/Commentary

The CD91 receptor has been shown to coexpress with CD163 and CD33 in monocyte/macrophage cells (7). [...]the depletion of monocytes/macrophages by the GO therapy may interfere with hemoglobin metabolism and attenuate bilirubin production. Monocytes and macrophages are the primary cells involved in the clearance of the hemoglobin-haptoglobin complex. [...]persistent bone marrow suppression due to chemoablation may explain why the hemolytic episode continued even after the chemotherapy was stopped (Table 1). Because of the persistent infection, he did not qualify for bone marrow transplantation or further chemotherapy. [...]haptoglobin concentrations in patients treated with GO can be deceiving, and prolonged hemolytic episodes can be masqueraded by normal/increased haptoglobin values concurrent with normal K+ concentrations.