title: Successful induction and maintenance of long-term remission in a child with chronic relapsing autoimmune hemolytic anemia using rituximab.
abstract: Childhood autoimmune hemolytic anemia (AIHA) of the warm type is usually successfully managed with corticosteroids and/or immunoglobulin infusions. In a small proportion of patients AIHA follows a more severe and protracted pathway resulting in the use of immunosuppressive therapy and frequently culminating with the need for splenectomy. Rituximab is an anti-CD20 (B-cell) monoclonal antibody used for the treatment of patients with relapsed or refractory low-grade or follicular, CD20 positive, B-cell non-Hodgkin's lymphoma. Case reports on the use of rituximab for childhood AIHA are scant. The authors describe the first report in which rituximab was effectively employed to induce a long-term remission in a young child with the longest history of chronic relapsing AIHA prior to receiving rituximab. All immunosuppressive therapy was successfully discontinued and splenectomy was avoided.
authors.affiliation: Department of Pediatric Oncology and Hematology, Princess Margaret Hospital for Children, Perth, Western Australia. nick.gottardo@health.wa.gov.au
authors.forename: Nick G
authors.initials: NG
authors.lastname: Gottardo
authors.forename: David L
authors.initials: DL
authors.lastname: Baker
authors.forename: Frank R
authors.initials: FR
authors.lastname: Willis
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000188:drug therapy*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000032:analysis; D001402:B-Lymphocytes / Q000187:drug effects; D002908:Chronic Disease; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007223:Infant; D011239:Prednisolone / Q000627:therapeutic use; D012008:Recurrence; D012074:Remission Induction / Q000379:methods; D000069283:Rituximab; D013163:Splenomegaly; D013995:Time
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D007166:Immunosuppressive Agents; D000069283:Rituximab; D016572:Cyclosporine; D011239:Prednisolone