Successful resumption of epoetin alfa after rituximab treatment in a patient with pure red cell aplasia.
An 80-year-old man with chronic renal failure (CRF) had pure red cell aplasia (PRCA) 9 months after starting the subcutaneous administration of recombinant human erythropoietin alfa (rHuEPO-alpha). Owing to the advanced renal failure, conventional immunosuppressive therapies were not practicable. It was decided to administer rituximab (4 cycles of 375 mg/m2/wk). PRCA was treated successfully with rituximab. The administration of rHuEPO-alpha then was resumed via the intravenous route with a satisfactory correction of anemia (12 months after the EPO-alpha rechallenge the patient is still transfusion independent). To the authors' knowledge, this is the first report of (1) a successful treatment with rituximab with CD20 depletion in a CRF patient with PRCA and (2) a successful intravenous resumption of the same rHuEPO-alpha.
Mandreoli
Marcora
M
Department of Nephrology and Dialysis, Policlinico S. Orsola, Malpighi, Bologna, Italy.
Finelli
Carlo
C
Lopez
Antonia
A
Ascani
Stefano
S
Vianelli
Nicola
N
Baccarani
Michele
M
Santoro
Antonio
A
D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000276:immunology; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000627:therapeutic use*; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D011994:Recombinant Proteins; D012010:Red-Cell Aplasia, Pure / Q000150:complications* / Q000188:drug therapy*; D000069283:Rituximab
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin; D000069283:Rituximab; D000068817:Epoetin Alfa