Rituximab-based immunosuppression for autoimmune haemolytic anaemia in infants.
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.
Svahn
Johanna
J
Haematology Unit, G Gaslini Children's Institute, Genova, Italy. johannasvahn@ospedale-gaslini.ge.it
Fioredda
Francesca
F
Calvillo
Michaela
M
Molinari
Angelo C
AC
Micalizzi
Concetta
C
Banov
Laura
L
Schmidt
Madalina
M
Caprino
Daniela
D
Marinelli
Doretta
D
Gallisai
Domenico
D
Dufour
Carlo
C
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
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007166:Immunosuppressive Agents; D000069283:Rituximab; D016572:Cyclosporine