A Multicenter, Prospective, Randomized Controlled Study Comparing Glucocorticoid Combined With Sirolimus With Monotherapy of Glucocorticoid in the Treatment of Newly Diagnosed Mild Autoimmune Hemolytic Anemia

Inclusion Criteria: 1. Age ≥18 years old, gender not limited; 2. Diagnosed as newly diagnosed wAIHA and requiring systemic immunosuppressive therapy (those with short-term hormone exposure of ≤2 weeks before enrollment can be included) 3. After a comprehensive rheumatology and immunology assessment, there is no evidence of clinical organ involvement in SLE or other connective tissue diseases (only serological abnormalities can be included). 4. Positive Coombs test (IgG type, IgG+C3d type, or only C3d type with a condensed agglutinin titer of 1:64); 5. Active hemolytic anemia, hemoglobin (HGB) ≤ 100 g/L; 6. Liver and kidney function: Alanine aminotransferase (ALT) \< 3 times the upper limit of the normal value (ULN), isolated elevation of aspartate aminotransferase (AST) (normal ALT) is acceptable; Serum creatinine ≤2×ULN; 7. Eastern Cooperative Oncology Group (ECOG) Performance status score ≤2 points; 8. Those with a history of malignant tumors must meet the following conditions: Radical treatment has been achieved; The disease-free survival period complies with the protocol provisions (such as ≥1 year for basal cell carcinoma, ≥5 years for early solid tumors, ≥5 years for curable lymphoma, etc.); There is currently no evidence of recurrence. Those who do not meet the above conditions (such as CLL, advanced solid tumors, and active tumors) are not included. 9. Voluntarily sign a written informed consent form. Exclusion Criteria: 1. Pregnant or lactating patients; 2. Clinically confirmed SLE or other definite connective tissue diseases; 3. Secondary AIHA secondary to lymphoproliferative diseases, other hematological malignancies, solid tumors, infections, and drugs; 4. Cold-resistant type or hybrid type AIHA; 5. Received before group enrollment: Other immunosuppressants (such as rituximab, cyclosporine, etc., regardless of the duration); Glucocorticoid treatment for more than 2 weeks; 6. Severe cardiac insufficiency (NYHA grade III/IV, or LVEF \< 40%); 7. Currently active malignant tumors, or previous tumors that do not meet the requirements of Article 8 of the inclusion criteria; 8. Chronic active infections (active tuberculosis, active hepatitis B/C, etc.); 9. Severe immunodeficiency diseases, HIV infection (CD4⁺ \< 200/μL), currently using other potent immunosuppressants, and using targeted biological agents within the last 3 months; 10. Have a history of severe allergy to sirolimus, glucocorticoids or related excipients; 11. Other circumstances where the researcher deems it inappropriate to participate.