title: [Autoimmune haemolytic anemia: diagnosis strategy and new treatments].
abstract: The pattern of autoimmune hemolytic anemia has changed significantly these last 15 years. With regard to the diagnosis strategy, the use of gel filtration technique to perform the direct antiglobulin test (DAT) has decreased the number of autoimmune haemolytic anemias with negative tests results. In recent years, autoimmune haemolytic anemia increased in patients receiving purine nucleoside analogues, blood transfusions, solid organ transplantation or hematopoietic stem cells transplantation. These difficult autoimmune haemolytic anemia cases need to use new kinds of treatments. With regard to the treatment, very little progress was made this latter 50 years. The discovery of the efficacy of anti-CD20 antibody in this disease represents a breakthrough. Nowdays, the second-line treatment includes rituximab or splenectomy. Sometimes, the anti-CD20 treatment could be proposed in first-line but some clinical trials are needed.
authors.affiliation: Laboratoire d'immunohématologie et service d'hémovigilance, établissement français du sang, 1-3, rue du Vercors, 69007 Lyon, France. dominique.rigal@efs.sante.fr
authors.forename: D
authors.initials: D
authors.lastname: Rigal
authors.forename: F
authors.initials: F
authors.lastname: Meyer
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000744:Anemia, Hemolytic, Autoimmune / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D018951:Antigens, CD20 / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D003131:Combined Modality Therapy; D003298:Coombs Test / Q000379:methods; D003449:Cryoglobulinemia / Q000175:diagnosis / Q000628:therapy; D019468:Disease Management; D005260:Female; D006086:Graft vs Host Disease / Q000097:blood; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007239:Infections / Q000097:blood / Q000150:complications; D009369:Neoplasms / Q000097:blood / Q000150:complications; D016377:Organ Transplantation / Q000009:adverse effects; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis / Q000188:drug therapy; D000069283:Rituximab; D013156:Splenectomy; D065227:Transfusion Reaction; D018183:Transplantation Chimera / Q000276:immunology
chemical_list: D000305:Adrenal Cortex Hormones; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D015415:Biomarkers; D007166:Immunosuppressive Agents; D000069283:Rituximab