Prompt response to rituximab of severe hemolytic anemia with both cold and warm autoantibodies

Authors

  • Duncan Webster,

    1. Division of Hematology and Oncology, Department of Medicine, University of Alberta and University of Alberta Hospital, Edmonton, Alberta, Canada
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  • Bruce Ritchie,

    1. Division of Hematology and Oncology, Department of Medicine, University of Alberta and University of Alberta Hospital, Edmonton, Alberta, Canada
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  • Michael J. Mant

    Corresponding author
    1. Division of Hematology and Oncology, Department of Medicine, University of Alberta and University of Alberta Hospital, Edmonton, Alberta, Canada
    • 2E3.32 Walter C. Mackenzie Health Sciences Centre, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada T6G 2R7
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Abstract

A 71-year-old male with severe autoimmune hemolysis with both cold agglutinins and warm antibodies was intolerant of prednisone and cyclophosphamide. Rituximab was given during a 60-day period when he required 41 units of packed cells to maintain hemoglobin above 75 g/l. Two weeks later hemoglobin stabilized at 95 g/l, and further transfusions were not required. A second course of rituximab was given 4 months later for continued hemolysis. A satisfactory hemoglobin was maintained for 9 months from initial treatment, when hemoglobin again fell to 65 g/L. A prompt response to a third course of rituximab was obtained. This is the second patient with both cold agglutinins and warm antibodies with severe hemolytic anemia who has had a prompt response to rituximab. This treatment should be considered when a rapid response is needed or when a patient has failed to respond to more standard therapies. Am. J. Hematol. 75:258–259, 2004. © 2004 Wiley-Liss, Inc.

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