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    A multi-centre retrospective study of rituximab use in the treatment of relapsed or resistant warm autoimmune haemolytic anaemia.

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    Authors
    Maung, Su W
    Leahy, Maeve
    O'Leary, Hilary M
    Khan, Irfan
    Cahill, Mary R
    Gilligan, Oonagh
    Murphy, Philip
    McPherson, Suzanne
    Jackson, Fred
    Ryan, Mary
    Hennessy, Brian
    McHugh, Johnny
    Goodyer, Matthew
    Bacon, Larry
    O'Gorman, Peter
    Nee, Aisling
    O'Dwyer, Michael
    Enright, Helen
    Saunders, Jean
    O'Keeffe, Denis
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    Affiliation
    Department of Haematology, University Hospital Limerick, Limerick, Ireland; Department of Haematology, Tallaght Hospital (AMNCH), Dublin, Ireland.
    Issue Date
    2013-10
    MeSH
    Adolescent
    Adult
    Aged
    Aged, 80 and over
    Anemia, Hemolytic, Autoimmune
    Antibodies, Monoclonal, Murine-Derived
    Female
    Humans
    Immunologic Factors
    Ireland
    Male
    Middle Aged
    Recurrence
    Retrospective Studies
    Treatment Outcome
    Young Adult
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    Citation
    A multi-centre retrospective study of rituximab use in the treatment of relapsed or resistant warm autoimmune haemolytic anaemia. 2013, 163 (1):118-22 Br. J. Haematol.
    Journal
    British journal of haematology
    URI
    http://hdl.handle.net/10147/322351
    DOI
    10.1111/bjh.12486
    PubMed ID
    23909468
    Additional Links
    http://onlinelibrary.wiley.com/doi/10.1111/bjh.12486/abstract
    Abstract
    This retrospective analysis assessed the response, safety and duration of response to standard dose rituximab 375 mg/m(2) weekly for four weeks as therapy for patients with primary or secondary warm autoimmune haemolytic anaemia (WAIHA), who had failed initial treatment. Thirty-four patients received rituximab for WAIHA in seven centres in the Republic of Ireland. The overall response rate was 70·6% (24/34) with 26·5% (9/34) achieving a complete response (CR). The time to response was 1 month post-initiation of rituximab in 87·5% (21/24) and 3 months in 12·5% (3/24) of patients. The median duration of follow-up was 36 months (range 6-90 months). Of the patients who responded, 50% (12/24) relapsed during follow up with a median time to next treatment of 16·5 months (range 6-60 months). Three patients were re-treated with rituximab 375 mg/m2 weekly for four weeks at relapse and responded. There was a single episode of neutropenic sepsis. Rituximab is an effective and safe treatment for WAIHA but a significant number of patients will relapse in the first two years post treatment. Re-treatment was effective in a small number of patients, suggesting that intermittent pulse treatment or maintenance treatment may improve long-term response.
    Item Type
    Article
    Language
    en
    ISSN
    1365-2141
    ae974a485f413a2113503eed53cd6c53
    10.1111/bjh.12486
    Scopus Count
    Collections
    Cork University Hospital

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