A multi-centre retrospective study of rituximab use in the treatment of relapsed or resistant warm autoimmune haemolytic anaemia
Maung, Su W.
O'Leary, Hilary M.
Cahill, Mary R.
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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 (2013). A multi-centre retrospective study of rituximab use in the treatment of relapsed or resistant warm autoimmune haemolytic anaemia. British Journal of Haematology 163 (1), 118-122
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 center dot 6% (24/34) with 26 center dot 5% (9/34) achieving a complete response (CR). The time to response was 1 month post-initiation of rituximab in 87 center dot 5% (21/24) and 3 months in 12 center dot 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 center dot 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.