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Rituximab‐based immunosuppression for autoimmune haemolytic anaemia in infants
Author(s) -
Svahn Johanna,
Fioredda Francesca,
Calvillo Michaela,
Molinari Angelo C.,
Micalizzi Concetta,
Banov Laura,
Schmidt Madalina,
Caprino Daniela,
Marinelli Doretta,
Gallisai Domenico,
Dufour Carlo
Publication year - 2009
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2009.07594.x
Subject(s) - rituximab , medicine , haemolysis , immunosuppression , prednisolone , autoimmune hemolytic anemia , immunology , evans syndrome , autoimmune lymphoproliferative syndrome , autoimmune thrombocytopenia , autoimmune disease , lymphoproliferative disease , anemia , pediatrics , gastroenterology , antibody , lymphoma , apoptosis , biochemistry , chemistry , fas receptor , programmed cell death
Summary We report a case series of four infants with severe autoimmune haemolytic anaemia (AIHA) who responded to treatment with rituximab and cyclosporine after having failed first line therapy with high‐dose steroid (prednisolone 4–8 mg/kg/d). Rituximab was started at 11–90 d from onset due to continued haemolysis; three infants also received cyclosporine A. Three of four infants reached complete response, defined as normal haemoglobin, reticulocytes and negative indices of haemolysis, at 7–21 months from diagnosis. In long‐term follow‐up two infants remained disease‐free with normal immunology, one had undefined immunodeficiency and one had autoimmune lymphoproliferative syndrome.