Journal
INTERNATIONAL JOURNAL OF HEMATOLOGY
Volume 104, Issue 4, Pages 462-467Publisher
SPRINGER JAPAN KK
DOI: 10.1007/s12185-016-2056-5
Keywords
Refractory autoimmune hemolytic anemia; Low dose rituximab; Intermittent intravenous cyclophosphamide
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Funding
- National Natural Science Foundation of China [81570106, 81570111, 814000888, 81400085]
- Tianjin Municipal Natural Science Foundation [14JCYBJC25400, 15JCYBJC24300]
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This retrospective study aims at confirming the efficacy and safety of low dose rituximab and pulse cyclophosphamide in the treatment of refractory AIHA in adults and making comparison of the two. Forty-nine adult patients with refractory AIHA have been enrolled. Results showed low dose rituximab combined with steroid therapy (group B) got more CR (78.9 %, 15/19) compared to that in intermittent intravenous cyclophosphamide combined with steroid therapy (group A) (42.1 %, 8/19) (P = 0.04) at 6 months after treatment. The hemoglobin level in group B was higher than group A at the time point of 1 month (P = 0.02) after treatments. The RFS in group A was 87.9 % at 6 months and 82.7 % at 12 months, which were no significant difference with group B (91.1 % at 6 months and 86.0 % at 12 months) (P = 0.81). Both the two therapies were well tolerated with pulmonary infections as the most common side effects. In conclusion, low dose rituximab combined with steroid therapy presents to be a better choice in the treatment of refractory AIHA in adults comparing with pulse cyclophosphamide therapy.
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