title: Efficacy and safety of splenectomy in adult autoimmune hemolytic anemia.
abstract: Autoimmune hemolytic anemia (AIHA) is a rare hematologic disease, primarily affecting adults or children with immunodeficiency disease. First-line therapy consists of long course of steroids administration, with an early complete response rate (CRr) of 75-80%, but up to 20-30% of patients requires a second-line therapy. Rituximab is the first choice in refractory old AIHA patients, because of its safety and efficacy (early CRr at 80-90% and at 68% at 2-3 years). For this reason, splenectomy is even less chosen as second-line therapy in elderly, even though laparoscopic technique decreased complication and mortality rates. However, splenectomy can be still considered a good therapeutic option with a CRr of 81% at 35.6 months in patients older than 60 year-old, when rituximab administration cannot be performed.
authors.affiliation: Hematology and Transplant Center, Department of Medicine and Surgery, University of Salerno, Salerno, 84131, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Giudice
authors.affiliation: Hematology and Transplant Center, Department of Medicine and Surgery, University of Salerno, Salerno, 84131, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Rosamilio
authors.affiliation: Hematology and Transplant Center, Department of Medicine and Surgery, University of Salerno, Salerno, 84131, Italy.
authors.forename: Idalucia
authors.initials: I
authors.lastname: Ferrara
authors.affiliation: Hematology and Transplant Center, Department of Medicine and Surgery, University of Salerno, Salerno, 84131, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Seneca
authors.affiliation: Hematology and Transplant Center, Department of Medicine and Surgery, University of Salerno, Salerno, 84131, Italy.
authors.forename: Bianca
authors.initials: B
authors.lastname: Serio
authors.affiliation: Hematology and Transplant Center, Department of Medicine and Surgery, University of Salerno, Salerno, 84131, Italy , Tel. +39 089673150, mobile: 3356166591.
authors.forename: Carmine
authors.initials: C
authors.lastname: Selleri
keywords: Autoimmune hemolytic anemia; Elderly; Splenectomy