Abstract
This prospective study investigated the efficacy, safety, and response duration of low-dose rituximab (100 mg fixed dose for 4 weekly infusions) together with a short course of steroids as first- or second-line therapy in 23 patients with primary autoimmune hemolytic anemia (AIHA). The overall response was 82.6% at month +2, and subsequently stabilized to ∼90% at months +6 and +12; the response was better in warm autoimmune hemolytic anemia (WAIHA; overall response, 100% at all time points) than in cold hemagglutinin disease (CHD; average, 60%); the relapse-free survival was 100% for WAIHA at +6 and +12 months versus 89% and 59% in CHD, respectively, and the estimated relapse-free survival at 2 years was 81% and 40% for the warm and cold forms, respectively. The risk of relapse was higher in CHD and in patients with a longer interval between diagnosis and enrollment. Steroid administration was reduced both as cumulative dose (∼50%) and duration compared with the patient's past history. Treatment was well tolerated and no adverse events or infections were recorded; retreatment was also effective. The clinical response was correlated with amelioration biologic markers such as cytokine production (IFN-γ, IL-12, TNF-α, and IL-17), suggesting that low-dose rituximab exerts an immu-nomodulating activity. This study is registered at www.clinicaltrials.gov as NCT01345708.
| Original language | English |
|---|---|
| Pages (from-to) | 3691-3697 |
| Number of pages | 7 |
| Journal | Blood |
| Volume | 119 |
| Issue number | 16 |
| DOIs | |
| Publication status | Published - Apr 19 2012 |
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ASJC Scopus subject areas
- Hematology
- Biochemistry
- Cell Biology
- Immunology
Cite this
Low-dose rituximab in adult patients with idiopathic autoimmune hemolytic anemia : Clinical efficacy and biologic studies. / Barcellini, Wilma; Zaja, Francesco; Zaninoni, Anna; Imperiali, Francesca Guia; Battista, Marta Lisa; Di Bona, Eros; Fattizzo, Bruno; Consonni, Dario; Cortelezzi, Agostino; Fanin, Renato; Zanella, Alberto.
In: Blood, Vol. 119, No. 16, 19.04.2012, p. 3691-3697.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Low-dose rituximab in adult patients with idiopathic autoimmune hemolytic anemia
T2 - Clinical efficacy and biologic studies
AU - Barcellini, Wilma
AU - Zaja, Francesco
AU - Zaninoni, Anna
AU - Imperiali, Francesca Guia
AU - Battista, Marta Lisa
AU - Di Bona, Eros
AU - Fattizzo, Bruno
AU - Consonni, Dario
AU - Cortelezzi, Agostino
AU - Fanin, Renato
AU - Zanella, Alberto
PY - 2012/4/19
Y1 - 2012/4/19
N2 - This prospective study investigated the efficacy, safety, and response duration of low-dose rituximab (100 mg fixed dose for 4 weekly infusions) together with a short course of steroids as first- or second-line therapy in 23 patients with primary autoimmune hemolytic anemia (AIHA). The overall response was 82.6% at month +2, and subsequently stabilized to ∼90% at months +6 and +12; the response was better in warm autoimmune hemolytic anemia (WAIHA; overall response, 100% at all time points) than in cold hemagglutinin disease (CHD; average, 60%); the relapse-free survival was 100% for WAIHA at +6 and +12 months versus 89% and 59% in CHD, respectively, and the estimated relapse-free survival at 2 years was 81% and 40% for the warm and cold forms, respectively. The risk of relapse was higher in CHD and in patients with a longer interval between diagnosis and enrollment. Steroid administration was reduced both as cumulative dose (∼50%) and duration compared with the patient's past history. Treatment was well tolerated and no adverse events or infections were recorded; retreatment was also effective. The clinical response was correlated with amelioration biologic markers such as cytokine production (IFN-γ, IL-12, TNF-α, and IL-17), suggesting that low-dose rituximab exerts an immu-nomodulating activity. This study is registered at www.clinicaltrials.gov as NCT01345708.
AB - This prospective study investigated the efficacy, safety, and response duration of low-dose rituximab (100 mg fixed dose for 4 weekly infusions) together with a short course of steroids as first- or second-line therapy in 23 patients with primary autoimmune hemolytic anemia (AIHA). The overall response was 82.6% at month +2, and subsequently stabilized to ∼90% at months +6 and +12; the response was better in warm autoimmune hemolytic anemia (WAIHA; overall response, 100% at all time points) than in cold hemagglutinin disease (CHD; average, 60%); the relapse-free survival was 100% for WAIHA at +6 and +12 months versus 89% and 59% in CHD, respectively, and the estimated relapse-free survival at 2 years was 81% and 40% for the warm and cold forms, respectively. The risk of relapse was higher in CHD and in patients with a longer interval between diagnosis and enrollment. Steroid administration was reduced both as cumulative dose (∼50%) and duration compared with the patient's past history. Treatment was well tolerated and no adverse events or infections were recorded; retreatment was also effective. The clinical response was correlated with amelioration biologic markers such as cytokine production (IFN-γ, IL-12, TNF-α, and IL-17), suggesting that low-dose rituximab exerts an immu-nomodulating activity. This study is registered at www.clinicaltrials.gov as NCT01345708.
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U2 - 10.1182/blood-2011-06-363556
DO - 10.1182/blood-2011-06-363556
M3 - Article
VL - 119
SP - 3691
EP - 3697
JO - Blood
JF - Blood
SN - 0006-4971
IS - 16
ER -