Objective: This study aimed to compare demographic characteristics, laboratory parameters, treatment modalities, and clinical outcomes between adult patients with primary and secondary warm autoimmune hemolytic anemia (wAIHA).
Materials and
Methods: This retrospective study included 85 adult patients (57 with primary and 28 with secondary wAIHA) diagnosed between January 2000 and December 2019. Data on baseline hemolytic markers, therapies (corticosteroids, splenectomy, and rituximab), and outcomes were reviewed. The mean age was 53.0±16.2 years, and 74.1% of the patients were female. Patients were assessed for treatment responses and mortality.

Results: No significant differences were observed between the primary and secondary wAIHA groups in terms of baseline hemoglobin, reticulocyte count, lactate dehydrogenase, or bilirubin. However, haptoglobin levels were significantly lower in the primary wAIHA group (p=0.027). Corticosteroid response rates exceeded 90% in both groups, though relapse occurred in 29.4% of responders. Splenectomy led to remission in all secondary and 92% of primary wAIHA cases. Rituximab was administered in only one patient due to reimbursement limitations. Overall mortality was 15.3%, with no significant difference between the primary and secondary groups (p>0.05).

Conclusion: Primary and secondary wAIHA patients show similar clinical and therapeutic profiles. Corticosteroids were highly effective as first-line therapy. Splenectomy showed high response rates, while rituximab usage was limited. Despite clinical differences such as lower haptoglobin in primary wAIHA, mortality rates did not differ significantly.