[Rituximab in cold agglutinin disease].
OBJECTIVE
Cold agglutinin disease is a chronic auto-immune hemolytic anemia related to a lymphoproliferative disorder with a degenerative potential and no codified treatment. This rare affection is related to the production of anti-erythrocytes immunoglobulins M. They are responsible of hemolytic crises sometimes severe and vascular acrosyndrom when submitted to cold temperature. Before rituximab, a monoclonal antibody targeted against the B lymphocyte CD20 antigen, no treatment was really efficient.


METHODS
We present 5 patients who have been treated with 4 weekly rituximab perfusions, and then we proceed to a review of the literature concerning the other 23 similar cases.


RESULTS
With a good tolerance, the treatment allowed a remission in all the cases (4 partial, 1 complete). Among the 23 observations published, the rate of answer was 21/23 (of which 14 gave completes).


CONCLUSIONS
Rituximab is an alternative treatment of cold agglutinin disease.
Camou
F
F
Service de médecine interne, centre François-Magendie, hôpital du Haut-Lévêque, CHU de Bordeaux, avenue Magellan, 33604 Pessac cedex, France.
Viallard
J-F
JF
Pellegrin
J-L
JL
D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000188:drug therapy* / Q000473:pathology; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000494:pharmacology*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007075:Immunoglobulin M; D008297:Male; D008875:Middle Aged; D000069283:Rituximab; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D007075:Immunoglobulin M; D000069283:Rituximab