title: Inhibitor eradication with rituximab in haemophilia: where do we stand?
abstract: Rituximab is a humanized chimeric anti-CD20 monoclonal antibody initially developed for the treatment of some haematological malignancies. Thanks to its ability to rapidly and specifically deplete B cells, it has also been used in a variety of autoimmune disorders, haematological or not. In this context, during the last decade several small case series have documented successful inhibitor eradication with rituximab, alone or in combination with other immunosuppressive agents, in patients with acquired haemophilia A refractory to standard therapy. In addition, a number of investigators have recently used this agent in patients with congenital haemophilia A or B and alloantibodies refractory to first-line treatment. This article critically reviews the current knowledge on the use of rituximab in acquired haemophilia or congenital haemophilia complicated by alloantibodies, also providing treatment algorithms for the management of these conditions.
authors.affiliation: Department of Transfusion Medicine and Haematology, Carlo Poma Hospital, Mantova, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Franchini
authors.forename: Pier Mannuccio
authors.initials: PM
authors.lastname: Mannucci
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005164:Factor IX / Q000037:antagonists & inhibitors / Q000276:immunology / Q000627:therapeutic use; D005169:Factor VIII / Q000037:antagonists & inhibitors / Q000276:immunology / Q000627:therapeutic use; D005260:Female; D006467:Hemophilia A / Q000188:drug therapy* / Q000276:immunology; D002836:Hemophilia B / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007518:Isoantibodies / Q000276:immunology; D008297:Male; D000069283:Rituximab
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D007518:Isoantibodies; D000069283:Rituximab; D005169:Factor VIII; D005164:Factor IX
keywords: acquired haemophilia; alloantibodies; autoantibodies; congenital haemophilia; inhibitors; rituximab