title: Efficacy and safety of rituximab in adults' warm antibody autoimmune haemolytic anemia: retrospective analysis of 27 cases.
abstract: To better assess the efficacy and safety of rituximab in adults' warm antibody autoimmune hemolytic anemia (wAIHA), we conducted a retrospective study including 27 adults (mean age 49.7 +/- 21 years) with either primary (n = 17) or secondary (n = 10) wAIHA. On average, the patients received 2.1 +/- 1.4 treatment lines before rituximab and six had undergone splenectomy. Five patients were resistant to corticosteroids, 16 had a corticosteroid-dependent wAIHA and six had relapsed after an initial remission. Overall, 25/27 (93%) patients achieved an initial response from rituximab (eight complete responses and 17 partial responses). During a mean follow-up of 20.9 months after rituximab, five of the responders relapsed, three of whom were successfully retreated with rituximab. Two mild infusion-related-reactions occurred, one patient had a rituximab-related severe neutropenia and one case of pneumocystis jiroveci pneumonia occurred in a severely immunocompromized patient. In conclusion, rituximab seems highly effective and relatively safe in adults with steroid-resistant or steroid-dependent wAIHA.
authors.affiliation: Department of Internal Medicine, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris, Université Paris 12, Créteil, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Bussone
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Ribeiro
authors.forename: Agnès
authors.initials: A
authors.lastname: Dechartres
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Viallard
authors.forename: Bernard
authors.initials: B
authors.lastname: Bonnotte
authors.forename: Olivier
authors.initials: O
authors.lastname: Fain
authors.forename: Bertrand
authors.initials: B
authors.lastname: Godeau
authors.forename: Marc
authors.initials: M
authors.lastname: Michel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000188:drug therapy*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000069283:Rituximab; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab