Successful treatment with rituximab for autoimmune hemolytic anemia concomitant with proliferation of Epstein-Barr virus and monoclonal gammopathy in a post-nonmyeloablative stem cell transplant patient.
A 30-year-old Japanese woman who underwent nonmyeloablative stem cell transplantation from her HLA-matched sister developed autoimmune hemolytic anemia (AIHA). There was proliferation of EBV-DNA in her peripheral blood and monoclonal gammopathy, both predictive factors of post-transplant lymphoproliferative disorder (PTLD). As conventional immunosuppressive therapy for AIHA could lead to overt PTLD, we decided to give her rituximab 375 mg/m(2) once weekly for a total of four doses. After this therapy, both her AIHA and monoclonal gammopathy were resolved and EBV-DNA became undetectable. Rituximab therapy deserves consideration for treatment of post-allogeneic stem cell transplant patients with AIHA, especially for patients who cannot be given immunosuppressive therapy.
D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000627:therapeutic use; D004279:DNA, Viral / Q000097:blood; D020031:Epstein-Barr Virus Infections / Q000097:blood / Q000150:complications*; D005260:Female; D006242:Haptoglobins / Q000032:analysis; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D007963:Leukocytes, Mononuclear / Q000821:virology; D008232:Lymphoproliferative Disorders / Q000097:blood / Q000150:complications; D019653:Myeloablative Agonists / Q000627:therapeutic use; D010265:Paraproteinemias / Q000097:blood / Q000150:complications*; D011183:Postoperative Complications / Q000097:blood / Q000188:drug therapy; D000069283:Rituximab; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D019172:Transplantation Conditioning / Q000379:methods; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D004279:DNA, Viral; D006242:Haptoglobins; D006454:Hemoglobins; D007136:Immunoglobulins; D019653:Myeloablative Agonists; D000069283:Rituximab