Rituximab is an effective and safe treatment of relapse in elderly patients with resistant warm AIHA

Ann Hematol. 2016 Apr;95(5):765-9. doi: 10.1007/s00277-016-2605-2. Epub 2016 Feb 9.

Abstract

We evaluated the efficacy and safety of rituximab for the treatment of 23 elderly patients (median age 78 years) with warm autoimmune haemolytic anaemia (AIHA). The median follow-up was 31 months. Patients had received one to five previous treatments. Rituximab was administered by intravenous infusion at a dose of 375 mg/m(2) once weekly for 4 weeks. The OR rate was 86.9 % (CR = 39.1 %, PR = 47.8 %). Median OS was 87 months. The median OS of patients who reached CR could not be calculated, and that of patients with PR was 67 months. At last follow-up, eight of the 20 responding patients, including one patient in CR and seven in PR, had relapsed after a median of 6 months. Failure to achieve CR was a risk factor for relapse (p = 0.028). We did not identify any pretreatment characteristics predictive of response to rituximab. In conclusion, rituximab is an effective treatment for elderly patients with refractory warm AIHA.

Keywords: Elderly; Haemolytic autoimmune anaemia; Relapse; Rituximab; Safety.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Aged
  • Aged, 80 and over
  • Anemia, Hemolytic, Autoimmune / drug therapy*
  • Anemia, Hemolytic, Autoimmune / immunology
  • Autoantibodies / immunology
  • Combined Modality Therapy
  • Disease-Free Survival
  • Drug Evaluation
  • Female
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunosuppressive Agents / therapeutic use*
  • Kaplan-Meier Estimate
  • Male
  • Recurrence
  • Remission Induction
  • Retrospective Studies
  • Rituximab / therapeutic use*
  • Salvage Therapy
  • Splenectomy
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Autoantibodies
  • Immunoglobulins, Intravenous
  • Immunosuppressive Agents
  • Rituximab