Rituximab-based immunosuppression for autoimmune haemolytic anaemia in infants

Br J Haematol. 2009 Apr;145(1):96-100. doi: 10.1111/j.1365-2141.2009.07594.x. Epub 2009 Feb 4.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Anemia, Hemolytic, Autoimmune / drug therapy*
  • Anemia, Hemolytic, Autoimmune / immunology
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Murine-Derived
  • Cyclosporine / therapeutic use
  • Female
  • Follow-Up Studies
  • Hemolysis / drug effects
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Infant
  • Male
  • Remission Induction
  • Rituximab
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Immunosuppressive Agents
  • Rituximab
  • Cyclosporine