Rituximab-induced acute liver failure after an allogeneic transplantation for chronic myeloid leukemia.
Autoimmune hemolytic anemia (AIHA) is a well-recognized complication of allogeneic bone marrow transplantation (BMT) and can affect up to 5% patients. Several recent case reports suggested the efficacy of anti-CD20 monoclonal antibody, rituximab, in treating this condition. We report our experience with a 21-year-old female with accelerated-phase chronic myeloid leukemia who underwent allogeneic hematopoietic stem cell transplantation from a matched, unrelated donor. The patient developed autoimmune hemolytic anemia that failed to respond to steroids, intravenous immunoglobulins, and plasma exchange. She was then treated with rituximab that resulted in fatal acute liver toxicity.
Qazilbash
Muzaffar H
MH
Department of Blood and Marrow Transplantation, UT-MD Anderson Cancer Center, Houston, 77030, USA. mqazilba@mdanderson.org
Qu
Zhenhong
Z
Hosing
Chitra
C
Couriel
Daniel
D
Donato
Michele
M
Giralt
Sergio
S
Champlin
Richard
R
D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006650:Histocompatibility Testing; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy / Q000628:therapy*; D008099:Liver / Q000473:pathology; D017114:Liver Failure, Acute / Q000139:chemically induced* / Q000473:pathology; D009336:Necrosis; D000069283:Rituximab; D014184:Transplantation, Homologous
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab