Refractory IgG Warm Autoimmune Hemolytic Anemia Treated with Eculizumab: A Novel Application of Anticomplement Therapy.
Warm autoimmune hemolytic anemia (wAIHA) is the most common form of AIHA, with corticosteroids in first-line treatment resulting in a 60-80% response rate. Atypical wAIHA and IgG plus complement mediated disease have a higher treatment failure rate and higher recurrence rate. We report a case of severe wAIHA secondary to Waldenström macroglobulinemia with life threatening intravascular hemolysis refractory to prednisone, rituximab, splenectomy, and plasmapheresis. A four-week treatment of eculizumab in this heavily pretreated patient resulted in a sustained increase in hemoglobin and transfusion independence, suggesting a role for complement inhibition in refractory wAIHA.
Department of Medicine, Division of Hematology, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Room E-725, Montreal, QC, Canada H3T 1E2.
Kim
K
Ma
Department of Medicine, Division of Hematology, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Room E-725, Montreal, QC, Canada H3T 1E2.
Stephen
S
Caplan