Remission of severe cold agglutinin disease Rituximab therapy

Layios, Nathalie; Neste, Éric Van Den; Jost, Edgar; Deneys, Véronique; Scheiff, J. M.; Ferrant, Augustin

doi:10.1038/sj.leu.2401976

Cited by 38 publications

(32 citation statements)

References 8 publications

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“…Rituximab has been used with varying success in the treatment of antibody-mediated cytopenias including autoimmune hemolytic anemia [2,5,6,[10][11][12]15,16]. In our patient who had warm IgM autoantibodymediated autoimmune hemolytic anemia, a disease with a known poor clinical outcome, it seems to have been a safe and effective therapy.…”

Section: Discussionmentioning

confidence: 85%

“…Because rituximab also removes normal antibody-producing B lymphocytes, it has been used to treat patients with antibody-mediated cytopenias *Correspondence to: Mary Wakim, MD, Division of Clinical Immunology and Allergy, CHLA, 4650 Sunset Blvd., Mailstop #75, Los Angeles, CA 90027. E-mail: Mwakim@chla.usc.edu with some success [5][6][7][8][9][10][11][12][13][14][15][16]. We report a case of a 6-yearold child with common variable immunodeficiency and autoimmune hemolytic anemia due to warm reactive IgM autoantibody that responded to therapy with rituximab.…”

Section: Introductionmentioning

confidence: 99%

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Successful anti‐CD20 monoclonal antibody treatment of severe autoimmune hemolytic anemia due to warm reactive IgM autoantibody in a child with common variable immunodeficiency

et al. 2004

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Autoimmune hemolytic anemia due to warm reactive IgM autoantibodies is unusual, severe, and often fails to respond to standard immunosuppressive therapies in both adults and children. A 6-year-old girl with common variable immunodeficiency had longstanding steroid dependent, splenectomy-unresponsive, warm IgM autoantibody-mediated autoimmune hemolytic anemia. Rituximab, a monoclonal antibody directed against CD20 antigen, was used to deplete B lymphocytes and reduce autoantibody production. She received a total of six doses of rituximab (375 mg/m 2 ). Therapy was well tolerated, and B-lymphocytes were effectively depleted from the peripheral blood. The patient was completely tapered off glucocorticoids. The patient has remained off immunosuppressive agents for 16 months despite the return of B lymphocytes to the peripheral circulation. She continues to require IVIG. Early treatment with rituximab might be an option for patients with warm reactive IgM autoantibody-mediated autoimmune hemolytic anemia not responding to other treatments or experiencing untoward side effects from those treatments. Am.

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Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Successful anti‐CD20 monoclonal antibody treatment of severe autoimmune hemolytic anemia due to warm reactive IgM autoantibody in a child with common variable immunodeficiency

et al. 2004

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“…1,2 Because the risk of late sequelae after TBI and BMT is inversely proportional to age, 3,4 attempts have been made to delay transplantation until the patient is older or to eliminate TBI from the conditioning regimen. 5 These approaches are advised, provided that survival is not compromised.…”

Section: Responsementioning

confidence: 99%

“…1 Previous reports document that cold agglutinins are responsive to Rituximab. 2,3 However, after multiple transfusions, the patient developed multiple red cell alloantibodies. The presence of the antiKpb made transfusions very difficult since this antigen is expressed by Ͼ99% of the population.…”

Section: W Leungmentioning

confidence: 99%

Clearance of erythrocyte allo-antibodies using Rituximab

Gryn

Zeigler

Shadduck

2002

Bone Marrow Transplant

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“…Treatment was well tolerated. Rituximab was effective in achieving long-term remissions in several other patients with refractory idiopathic CAD [31][32][33][34][35][36][37] and mixed warm and cold AIHA [38]. Pulik et al, on the basis of their experience with a single patient, suggested that patients with CAD who respond poorly to induction therapy with rituximab, may benefit from maintenance treatment, e.g., one injection of the antibody every 2 months [39].…”

Section: Type II Mixed Cryoglobulinemia and Cold Agglutinin Disease (mentioning

confidence: 99%

Rituximab for refractory Evans syndrome and other immune‐mediated hematologic diseases

et al. 2004

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The authors describe a 21-year-old man with long-lasting Evans syndrome refractory to corticosteroids and immunosuppressive agents; the patient responded to four weekly infusions of rituximab. The patient relapsed with thrombocytopenia 7 months post-therapy and was successfully re-treated with two weekly doses of the same monoclonal antibody. He remains in remission for 7-plus months after the second treatment. Therapy was well tolerated, and no infectious complications occurred, despite avoiding administration of prophylactic gammaglobulin. Rituximab appears safe and modestly effective in a variety of immune-mediated hematologic diseases, including autoimmune hemolytic anemia, chronic immune thrombocytopenia, Evans syndrome, pure red cell aplasia, mixed type II cryoglobulinemia, cold agglutinin disease, and Waldenströ m's macroglobulinemia. However, as most of the published literature consists of case reports and small case series, international collaboration is essential in order to better define the efficacy and safety of this agent in children and adults with hematologic diseases. Am.

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Remission of severe cold agglutinin disease Rituximab therapy

Cited by 38 publications

References 8 publications

Successful anti‐CD20 monoclonal antibody treatment of severe autoimmune hemolytic anemia due to warm reactive IgM autoantibody in a child with common variable immunodeficiency

Successful anti‐CD20 monoclonal antibody treatment of severe autoimmune hemolytic anemia due to warm reactive IgM autoantibody in a child with common variable immunodeficiency

Clearance of erythrocyte allo-antibodies using Rituximab

Rituximab for refractory Evans syndrome and other immune‐mediated hematologic diseases

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