title: Rituximab in chronic cold agglutinin disease: a prospective study of 20 patients.
abstract: Chronic cold agglutinin disease (CAD) is an acquired autoimmune hemolytic anemia. Previous therapeutic modalities, including alkylating cytostatics, interferon and prednisolone, have been disappointing. However, several case reports and small-scaled studies have demonstrated promising results after treatment with rituximab. We performed a phase II multicentre trial to investigate the effect of rituximab in CAD, including 20 patients studied from October 2002 until April 2003. Thirteen patients had idiopathic CAD and seven patients had CAD associated with a malignant B-cell lymphoproliferative disease. Rituximab was given in doses of 375 mg/m(2) at days 1, 8, 15 and 22. Sixteen patients were followed up for at least 48 weeks. Four patients were excluded after 8, 16, 23 and 28 weeks for reasons unrelated to CAD. Nine patients (45%) responded to the treatment, one with complete response (CR), and eight with partial response. Eight patients relapsed, one patient was still in remission at the end of follow-up. There were no serious rituximab-related side-effects. Our study confirms previous findings of a favourable effect of rituximab in patients with CAD. However, few patients will obtain CR and, in most patients, the effect will be transient.
authors.affiliation: Department of Hematology, Herlev University Hospital, Herlev, Denmark.
authors.forename: Claudia
authors.initials: C
authors.lastname: Schöllkopf
authors.forename: Lars
authors.initials: L
authors.lastname: Kjeldsen
authors.forename: Ole Weiss
authors.initials: OW
authors.lastname: Bjerrum
authors.forename: Hans Torben
authors.initials: HT
authors.lastname: Mourits-Andersen
authors.forename: Johan Lanng
authors.initials: JL
authors.lastname: Nielsen
authors.forename: Bjarne Egelund
authors.initials: BE
authors.lastname: Christensen
authors.forename: Bjarne Anker
authors.initials: BA
authors.lastname: Jensen
authors.forename: Bjarne Bach
authors.initials: BB
authors.lastname: Pedersen
authors.forename: Ellen Birkerod
authors.initials: EB
authors.lastname: Taaning
authors.forename: Tobias Wirenfeldt
authors.initials: TW
authors.lastname: Klausen
authors.forename: Henrik
authors.initials: H
authors.lastname: Birgens
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000744:Anemia, Hemolytic, Autoimmune / Q000188:drug therapy*; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012074:Remission Induction; D000069283:Rituximab
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab