{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:18:30Z","timestamp":1787739510819,"version":"build-2784847793"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anti\u2010AnWj autoantibody production with concomitant antigen suppression rarely has been reported secondary to lymphoid malignancy. Anti\u2010AnWj autoantibodies are often considered clinically insignificant; however, cases of posttransfusion hemolysis have been documented which require transfusion of AnWj\u2010negative red blood cells (RBC). AnWj\u2010negative RBC units are rare, thus options for long\u2010term transfusion are limited. We report the novel use of sutimlimab, a classical complement pathway inhibitor, for severe anemia in a patient with a complement fixing anti\u2010AnWj autoantibody.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 57\u2010year\u2010old male with high\u2010grade B\u2010cell lymphoma presented with severe anemia and was found to have an anti\u2010AnWj autoantibody of IgM and IgG isotypes and a complement\u2010positive direct antiglobulin test. AnWj\u2010positive RBC were provided for transfusion. His hemoglobin did not augment, and he developed evidence of hemolysis following crossmatch\u2010incompatible RBC units. Transfusion of In(Lu) RBC showed initial response; however, his anemia persisted. Sutimlimab was subsequently initiated based on the complement fixing ability of the autoantibody. An improvement in hemoglobin, decrease in lactate dehydrogenase, and decrease in RBC\u2010bound complement fragments were observed following sutimlimab administration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Management strategies for clinically significant anti\u2010AnWJ are not well defined. To our knowledge, this is the first case using sutimlimab to manage complement\u2010mediated hemolysis due to an auto\u2010anti\u2010AnWj antibody. While initial response to sutimlimab was favorable, the patient's comorbid lymphoma, multiple therapies, and short treatment period limit definitive conclusions regarding efficacy. Anti\u2010complement therapy warrants further study for refractory antibody\u2010mediated hemolysis with evidence of complement activation in the absence of compatible transfusions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70367","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T09:30:04Z","timestamp":1787736604000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Use of sutimlimab to manage anemia in a patient with high\u2010grade\n                    <scp>B<\/scp>\n                    \u2010cell lymphoma and complement binding anti\u2010\n                    <scp>AnWj<\/scp>\n                    autoantibody"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7636-1187","authenticated-orcid":false,"given":"Kathy","family":"Haddaway","sequence":"first","affiliation":[{"name":"Division of Transfusion Medicine, Department of Pathology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0507-0636","authenticated-orcid":false,"given":"Sri Bharathi","family":"Kavuri","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine, Department of Pathology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0650-2928","authenticated-orcid":false,"given":"Nikhil","family":"Ranjan","sequence":"additional","affiliation":[{"name":"Department of Hematology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jireh","family":"Oncita","sequence":"additional","affiliation":[{"name":"Immunohematology Reference Laboratory, American Red Cross  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5911-3873","authenticated-orcid":false,"given":"Cole","family":"Sterling","sequence":"additional","affiliation":[{"name":"Department of Oncology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0617-7256","authenticated-orcid":false,"given":"Michael","family":"Cole","sequence":"additional","affiliation":[{"name":"Department of Hematology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6026-1421","authenticated-orcid":false,"given":"Matthew","family":"Lankiewicz","sequence":"additional","affiliation":[{"name":"Department of Hematology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5741-1255","authenticated-orcid":false,"given":"Robert","family":"Brodsky","sequence":"additional","affiliation":[{"name":"Department of Hematology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0517-3766","authenticated-orcid":false,"given":"Aaron A. R.","family":"Tobian","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine, Department of Pathology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1910-2800","authenticated-orcid":false,"given":"Elizabeth P.","family":"Crowe","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine, Department of Pathology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9855-0075","authenticated-orcid":false,"given":"Gloria","family":"Gerber","sequence":"additional","affiliation":[{"name":"Department of Hematology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","DOI":"10.1002\/9781118493595","volume-title":"Human blood groups","author":"Daniels G","year":"2013"},{"issue":"26","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1182\/blood.2024025099","article-title":"Deletions in the MAL gene result in loss of mal protein, defining the rare inherited AnWj\u2010negative blood group phenotype","volume":"144","author":"Tilley LA","year":"2024","journal-title":"Blood"},{"key":"e_1_2_10_4_1","first-page":"612","article-title":"Autoantibody to a high\u2010frequency Lutheran antigen associated with immune hemolytic anemia and a hemolytic transfusion episode","volume":"21","author":"Fitzsimmons 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