Abstract: Objective: To compare the therapeutic effects of plasma exchange and red blood cell transfusion following white blood cell filtration on the patients with autoimmune hemolytic anemia(AIHA).Methods: A total of 104 patients with AIHA admitted to our hospital from February 2018 to May 2020 were enrolled and randomly divided into exchange group(50 cases, plasma exchange) and transfusion group(54 cases, red blood cell transfusion following white blood cell filtration). The coagulation function(prothrombin time[PT], activated partial thromboplastin time[APTT], thrombin time[TT])and fibrinolytic function(plasminogen[Plg], D-dime[DD], plasminogen activator inhibitor-1[PAI-1]) before and after treatment, and adverse reactions(fever, allergic reactions and transfusion induced purpura) were compared between the two groups. The curative effect and safety in both groups were evaluated.Results: There was no significant difference in the response rate between the two groups(96.00% vs. 88.89%, P>0.05). There were no significant differences in PT, APTT, TT, Plg, DD and PAI-1 levels between the two groups before treatment(P>0.05). After treatment, PT, APTT, TT and Plg levels in the transfusion group were significantly higher than those in the exchange group, while levels of DD and PAI-1 were significantly lower than those in the exchange group(P<0.05). The total incidence of fever, allergic reactions and transfusion induced purpura in the transfusion group was significantly lower than that in the exchange group(3.70% vs. 16.00%, P<0.05).Conclusion: Both red blood cell transfusion following white blood cell filtration and plasma exchange may be effective in the treatment of AIHA patients. However, the former can better improve the patients' coagulation-fibrinolysis function, with higher safety.