Bendamustine-induced immune hemolytic anemia in a chronic lymphocytic leukemia patient: a case report and review of the literature

Bendamustine is an alkylating agent approved for the treatment of chronic lymphocytic leukemia [CLL] and B-cell non-Hodgkin lymphoma. There are scant reports on bendamustine-induced immune hemolytic anemia occurring mainly in CLL patients. We report a case of immune hemolytic anemia that developed after exposure to bendamustine in a 70-year-old female with CLL who was previously exposed to fludarabine. Previous exposure to fludarabine is a common finding in the majority of reported cases of bendamustine drug-induced immune hemolytic anemia [DIIHA], including our case. Bendamustine should be suspected as the cause of any hemolytic anemia that develops while on this drug, especially in CLL patients treated previously with fludarabine