title: Long lasting remission by rituximab in a patient with primary cold agglutinin autoimmune haemolytic anaemia.
abstract: A 76-year-old female patient with cold agglutinin autoimmune haemolytic anaemia (CAHA) is presented. The haemolysis worsened during infection. Earlier, the patient underwent an unsuccessful treatment with steroids, chlorambucil , folic acid and heated erythrocyte transfusion. We treated her with monoclonal anti-CD20 antibody Rituximab (RTX) weekly for four consecutive weeks. After three cycles, the signs of haemolysis slowly disappeared and haemoglobin completely normalized. We continued with the maintenance treatment with RTX every third month for 2 years. The patient is in complete remission. This case report emphasizes the importance of the use of RTX as a therapy for immune cytopenia. Patients with CAHA usually fail to respond to standard treatment. Since CAHA is a very rare condition, only some case reports and 2 studies reported on the positive effects of RTX. Although expensive, RTX has many advantages, such as quick and long-term efficiency and only a few side effects.
authors.affiliation: Department of Haematology and Haematological Oncology, Clinical Division of Internal Medicine, University Medical Centre Maribor, Slovenia. m.glaser@ukc-mb.si
authors.forename: Marjana
authors.initials: M
authors.lastname: Glaser
authors.forename: Andrej
authors.initials: A
authors.lastname: Glaser
authors.forename: Marjan
authors.initials: M
authors.lastname: Skalicky
mesh_terms: D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000175:diagnosis* / Q000188:drug therapy*; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D008137:Longitudinal Studies; D012074:Remission Induction; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab