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Cold antibody-mediated autoimmune hemolytic anemia (cAIHA) is a rare disease, usually related to an underlying indolent clonal B-cell lymphoproliferative disorder. Jalink and colleagues describe an international retrospective analysis of Bruton tyrosine kinase (BTK) inhibition in patients with cAIHA. The data indicate a rapid and notable improvement in both the hemolytic anemia as well as acrocyanosis, suggesting that this may be an effective approach, regardless of underlying pathology or MYD88 mutational status.