Refractory idiopathic cold agglutinin disease successfully treated with intermittent high-dose cyclophosphamide

• Published in: Rinshō ketsueki Vol. 42; no. 9; p. 713
• Main Authors: Nakagawa, M, Miyagishima, T, Kamata, T, Arai, S, Miura, Y, Onishi, S, Kishimoto, A, Kamishima, Y, Choi, G H, Kudo, M, Okabe, M
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.09.2001
• Subjects: Anemia, Hemolytic, Autoimmune - drug therapy; Cyclophosphamide - administration & dosage; Drug Administration Schedule; Female; Humans; Immunosuppressive Agents - administration & dosage; Middle Aged; Treatment Outcome
• ISSN: 0485-1439
• DOI: 10.11406/rinketsu.42.713

A 56-year-old woman, who had been suffering from idiopathic cold agglutinin disease and treated unsuccessfully with prednisolone and cyclosporine A for 6 months, was referred to our hospital in November 1998. She was given methylprednisolone pulse therapy followed by low-dose cyclophosphamide, but her anemia did not improve. We then began administration of intermittent high-dose cyclophosphamide (1,200 mg/day, every 4 weeks), and this resulted in a dramatic increase of her hemoglobin level and improvement of her symptoms. She is currently receiving 500 mg of cyclophosphamide every 2 months and showing a good response. Intermittent high-dose cyclophosphamide therapy can be an effective treatment for refractory cold agglutinin disease.