Introduction. Diffuse large B-cell lymphoma (B-CDLL) until recently considered a rare histopathological subtype associated with autoimmune hemolytic anemia. Its clinical and pathological features have not yet been fully elucidated. Researches of recent years indicate a significant prevalence of the problem of autoimmune hemolysis in this group of patients, which requires a deeper study and analysis.

Aim.. The aim was the proportion determination of patients with diffuse large B-cell lymphoma with immunohematological signs of autoimmune hemolysis and serological characteristics of the detected antibodies and to evaluate relationship of antibodies with the degree of lymphoma aggressiveness and with the presence of    BCL-2, BCL-6 and C-MYC gene mutations.

Materials and  methods. 32 patients with B-CDLL were examined: 10 people (31 %) had stage IA, IE had 4 people (12,5 %), IIA – 4 people (12,5 %), IIIA – 4 people         (12,5 %), IVA – 9 (28 %) people; 1 patient had a recurrence of B-CDLL. R-CHOP, R-CHOEP schemes were used in the first line of treatment, and R-DHAP scheme was used in the second line of therapy. Methods was used: hematological (general blood test), immunohematological (gel micromethod, Bio-Rad, USA), immunohistochemical (detection of biomarkers BCL-2, BCL-6 and C-MYC in tumor cells).

Results. Autoimmune hemolytic reactions were detected in 25% of patients with B-CDLL. The full serological spectrum of antibodies of low concentration and of a low degree of activity was detected. It may be a reason to assess the degree of risk of hemolysis as low. Detected antibodies associated with anemia in 25 % of cases. Complementary type of autoimmune reactions or complex combination of anti-erythrocyte antibodies of different serological types and temperature optimum of action had association with the disease progression.

Conclusions. Autosensitization may be a prerequisite for the development of secondary autoimmune hemolysis in patients with B-CDLL. Modern treatment protocols for patients with B-CDLL usually prevent the development of an active hemolytic process with autoantibodies. The presence of anemia, older, middle, advanced and senile age of patients, refractoriness to treatment may indicate the possibility of an autoimmune hemolytic component.

Keywords: autoimmune hemolysis, diffuse large B-cell lymphoma, autoimmune anti-erythrocyte antibodies.