How Is Hemolytic Anemia Treated?

Treatments for hemolytic anemia include blood transfusions, medicines, plasmapheresis, surgery, blood and marrow stem cell transplants, and lifestyle changes.

People who have mild hemolytic anemia may not need treatment, as long as the condition doesn't worsen. People who have severe hemolytic anemia usually need ongoing treatment. Severe hemolytic anemia can be fatal if it's not properly treated.

Goals of Treatment

The goals of treating hemolytic anemia include:

• Reducing or stopping the destruction of red blood cells
• Increasing the red blood cell count to an acceptable level
• Treating the underlying cause of the condition

Treatment will depend on the type, cause, and severity of the hemolytic anemia you have. Your doctor also will consider your age, overall health, and medical history.

If you have an inherited form of hemolytic anemia, it's a lifelong condition that may require ongoing treatment. If you have an acquired form of hemolytic anemia, it may go away once its cause can be found and corrected.

Blood Transfusions

Blood transfusions are used to treat severe or life-threatening hemolytic anemia.

A blood transfusion is a common procedure in which blood is given to you through an intravenous (IV) line in one of your blood vessels. Transfusions require careful matching of donated blood with the recipient's blood.

Medicines

Medicines can improve some types of hemolytic anemia, especially autoimmune hemolytic anemia (AIHA). Corticosteroid medicines, such as prednisone, are used to limit or prevent your immune system from making antibodies against red blood cells.

If you don't respond to corticosteroids, your doctor may prescribe other medicines to suppress your immune system.

If you have severe sickle cell anemia, your doctor may recommend a medicine called hydroxyurea. This medicine reduces the number of red blood cells with abnormal hemoglobin that your body makes. It also promotes the production of red blood cells with normal hemoglobin.

Plasmapheresis

Plasmapheresis is a procedure that removes antibodies from the blood. For this procedure, blood is taken from your body using a needle inserted into a vein.

The plasma, which contains the antibodies, is separated from the rest of the blood. Then, plasma from a donor and the rest of the blood is put back in your body.

This treatment may help if other treatments for immune hemolytic anemia don't work.

Surgery

Some people who have hemolytic anemia may need surgery to remove their spleens. The spleen is an organ in the abdomen. A healthy spleen helps fight infection and filters out old or damaged blood cells.

An enlarged or diseased spleen may remove more red blood cells than normal, causing anemia. Removing the spleen can stop or reduce high rates of red blood cell destruction.

Blood and Marrow Stem Cell Transplant

In some types of hemolytic anemia, such as thalassemias, the bone marrow doesn't make enough healthy red blood cells. The red blood cells it does make may be destroyed before their normal lifespan is over. Blood and marrow stem cell transplants may be used to treat these types of hemolytic anemia.

A blood and marrow stem cell transplant replaces damaged stem cells with healthy ones from another person (a donor).

During the transplant, which is like a blood transfusion, you get donated stem cells through a tube placed in a vein. Once the stem cells are in your body, they travel to your bone marrow and begin making new blood cells.

Lifestyle Changes

If you have AIHA with cold-reactive antibodies, try to avoid cold temperatures. This can help prevent the breakdown of red blood cells. It's very important to protect your fingers, toes, and ears from the cold.

To protect yourself, you can:

• Wear gloves or mittens when taking food out of the refrigerator or freezer.
• Wear a hat, scarf, and a coat with snug cuffs during cold weather.
• Turn down air conditioning or dress warmly while in an air-conditioned space.
• Warm up the car before driving in cold weather.

People born with glucose-6-phosphate dehydrogenase (G6PD) deficiency can avoid substances that may trigger anemia. For example, avoid fava beans, naphthalene (a substance found in some moth balls), and certain medicines (as your doctor advises).