Alemtuzumab induced complete remission of autoimmune hemolytic anemia refractory to corticosteroids, splenectomy and rituximab.
A 58-year-old man with warm-antibody-mediated autoimmune hemolytic anemia (AIHA) refractory to prednisolone, azathioprine, splenectomy, rituximab and combination chemotherapy, and with unacceptably high transfusion requirement, was treated with alemtuzumab. After a cumulative dose of 883 mg of alemtuzumab, the AIHA remitted completely, with normalization of hemoglobin and transfusion-independence. The major side effect was reactivation of cytomegalovirus, which was controlled with intravenous and oral ganciclovir. This case showed that alemtuzumab might be of use in therapy-refractory AIHA.
Cheung
Winnie W
WW
Department of Medicine, Queen Mary Hospital, Pokfulam Road, Hong Kong.
Hwang
Gloria Y
GY
Tse
Eric
E
Kwong
Yok-Lam
YL
D000074323:Alemtuzumab; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications / Q000188:drug therapy* / Q000601:surgery / Q000628:therapy; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D000912:Antibodies, Neoplasm / Q000009:adverse effects / Q000627:therapeutic use*; D015703:Antigens, CD / Q000276:immunology; D000951:Antigens, Neoplasm / Q000276:immunology; D000998:Antiviral Agents / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D001803:Blood Transfusion; D000074301:CD52 Antigen; D003587:Cytomegalovirus / Q000187:drug effects / Q000502:physiology; D003586:Cytomegalovirus Infections / Q000150:complications / Q000188:drug therapy; D004351:Drug Resistance; D015774:Ganciclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D006023:Glycoproteins / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D012074:Remission Induction; D000069283:Rituximab; D013156:Splenectomy; D000077562:Valganciclovir; D014766:Viremia / Q000150:complications / Q000188:drug therapy; D014775:Virus Activation / Q000187:drug effects
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D000912:Antibodies, Neoplasm; D015703:Antigens, CD; D000951:Antigens, Neoplasm; D000998:Antiviral Agents; D000074301:CD52 Antigen; C000613862:CD52 protein, human; D006023:Glycoproteins; D007166:Immunosuppressive Agents; D000074323:Alemtuzumab; D000069283:Rituximab; D011239:Prednisolone; D000077562:Valganciclovir; D001379:Azathioprine; D015774:Ganciclovir