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

• Published in: British journal of haematology Vol. 163; no. 1; pp. 118 - 122
• Main 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
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell 01.10.2013
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anemia, Hemolytic, Autoimmune - complications; Anemia, Hemolytic, Autoimmune - drug therapy; Anemias. Hemoglobinopathies; Antibodies, Monoclonal, Murine-Derived - adverse effects; Antibodies, Monoclonal, Murine-Derived - therapeutic use; autoimmune haemolytic anaemia; Autoimmune hemolytic anemia; Biological and medical sciences; Diseases of red blood cells; Female; Hematologic and hematopoietic diseases; Humans; Immunologic Factors - adverse effects; Immunologic Factors - therapeutic use; Ireland; Male; Medical sciences; Middle Aged; multicentre; Recurrence; retrospective; Retrospective Studies; Rituximab; safety; Treatment Outcome; Tumors; Young Adult; Ireland; Antineoplastic agent; Autoimmunity; Immunopathology; Relapse; multi-centre; Hematology; autoimmune haemolytic anaemia; Multicenter study; Rituximab; Hemopathy; Monoclonal antibody; Retrospective; Resistance; Hemolytic anemia; Cancerology; Treatment; Autoimmune hemolytic anemia; Immunotherapy; safety; retrospective; multicentre; rituximab
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1111/bjh.12486

Summary This retrospective analysis assessed the response, safety and duration of response to standard dose rituximab 375 mg/m2 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.