期刊
WIENER KLINISCHE WOCHENSCHRIFT
卷 128, 期 7-8, 页码 234-237出版社
SPRINGER WIEN
DOI: 10.1007/s00508-015-0863-y
关键词
Warm autoimmune hemolytic anemia; steroids; long term remission
Background Primary warm autoimmune hemolytic anemia (WAIHA) is a rare autoimmune disorder frequently responding to corticosteroid first-line treatment and effective second-line treatment options such as splenectomy or anti-CD20 antibody therapy. Disease management is frequently hampered by a lack of evidence. Methods We have investigated the probability of sustained treatment-free remission after steroid induction to facilitate clinical decision making regarding timing and necessity of second-line treatments. Response data from 31 patients with primary WAIHA initially treated with steroids were retrospectively analyzed. All patients responded by achieving a hemoglobin of at least 10 mg/dl. Results After steroid tapering and final withdrawal, 9 of 30 patients remained in unsustained complete remission (CR). The probability of remaining in CR after steroid treatment only was 38.2 % (2 SD 20.6 %) at 15 months. The median remission duration was 100 + months with a range of 12 + to 163 + months. Of note, none of the remaining patients still on steroids achieved CR beyond 15 + months. Conclusion These data indicate that a considerable proportion of patients do not need further treatment and that relapses will not occur after 15 months in CR.
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