title: Rituximab-based immunosuppression for autoimmune haemolytic anaemia in infants.
abstract: We report a case series of four infants with severe autoimmune haemolytic anaemia (AIHA) who responded to treatment with rituximab and cyclosporine after having failed first line therapy with high-dose steroid (prednisolone 4-8 mg/kg/d). Rituximab was started at 11-90 d from onset due to continued haemolysis; three infants also received cyclosporine A. Three of four infants reached complete response, defined as normal haemoglobin, reticulocytes and negative indices of haemolysis, at 7-21 months from diagnosis. In long-term follow-up two infants remained disease-free with normal immunology, one had undefined immunodeficiency and one had autoimmune lymphoproliferative syndrome.
authors.affiliation: Haematology Unit, G Gaslini Children's Institute, Genova, Italy. johannasvahn@ospedale-gaslini.ge.it
authors.forename: Johanna
authors.initials: J
authors.lastname: Svahn
authors.forename: Francesca
authors.initials: F
authors.lastname: Fioredda
authors.forename: Michaela
authors.initials: M
authors.lastname: Calvillo
authors.forename: Angelo C
authors.initials: AC
authors.lastname: Molinari
authors.forename: Concetta
authors.initials: C
authors.lastname: Micalizzi
authors.forename: Laura
authors.initials: L
authors.lastname: Banov
authors.forename: Madalina
authors.initials: M
authors.lastname: Schmidt
authors.forename: Daniela
authors.initials: D
authors.lastname: Caprino
authors.forename: Doretta
authors.initials: D
authors.lastname: Marinelli
authors.forename: Domenico
authors.initials: D
authors.lastname: Gallisai
authors.forename: Carlo
authors.initials: C
authors.lastname: Dufour
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000188:drug therapy* / Q000276:immunology; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006461:Hemolysis / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D012074:Remission Induction; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007166:Immunosuppressive Agents; D000069283:Rituximab; D016572:Cyclosporine