Volume 163, Issue 1 pp. 118-122
Research Paper

A multi-centre retrospective study of rituximab use in the treatment of relapsed or resistant warm autoimmune haemolytic anaemia

Su W. Maung

Su W. Maung

Department of Haematology, University Hospital Limerick, Limerick, Ireland

Department of Haematology, Tallaght Hospital (AMNCH), Dublin, Ireland

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Maeve Leahy

Maeve Leahy

Department of Haematology, University Hospital Limerick, Limerick, Ireland

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Hilary M. O'Leary

Hilary M. O'Leary

Department of Haematology, University Hospital Limerick, Limerick, Ireland

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Irfan Khan

Irfan Khan

Department of Haematology, Cork University Hospital, Cork, Ireland

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Mary R. Cahill

Mary R. Cahill

Department of Haematology, Cork University Hospital, Cork, Ireland

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Oonagh Gilligan

Oonagh Gilligan

Department of Haematology, Cork University Hospital, Cork, Ireland

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Philip Murphy

Philip Murphy

Department of Haematology, Beaumont Hospital, Dublin, Ireland

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Suzanne McPherson

Suzanne McPherson

Department of Haematology, Waterford Regional Hospital, Waterford, Ireland

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Fred Jackson

Fred Jackson

Department of Haematology, Waterford Regional Hospital, Waterford, Ireland

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Mary Ryan

Mary Ryan

Department of Haematology, Waterford Regional Hospital, Waterford, Ireland

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Brian Hennessy

Brian Hennessy

Department of Haematology, Waterford Regional Hospital, Waterford, Ireland

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Johnny McHugh

Johnny McHugh

Department of Haematology, Tallaght Hospital (AMNCH), Dublin, Ireland

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Matthew Goodyer

Matthew Goodyer

Department of Haematology, Mater Misericordiae University Hospital, Dublin, Ireland

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Larry Bacon

Larry Bacon

Department of Haematology, Mater Misericordiae University Hospital, Dublin, Ireland

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Peter O'Gorman

Peter O'Gorman

Department of Haematology, Mater Misericordiae University Hospital, Dublin, Ireland

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Aisling Nee

Aisling Nee

Department of Haematology, University College Hospital, Galway, Ireland

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Michael O'Dwyer

Michael O'Dwyer

Department of Haematology, University College Hospital, Galway, Ireland

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Helen Enright

Helen Enright

Department of Haematology, Tallaght Hospital (AMNCH), Dublin, Ireland

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Jean Saunders

Jean Saunders

Statistical Consulting Unit/CSTAR @ UL, University of Limerick, Limerick, Ireland

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Denis O'Keeffe

Corresponding Author

Denis O'Keeffe

Department of Haematology, University Hospital Limerick, Limerick, Ireland

Correspondence: Dr Denis O'Keeffe, Department of Haematology, University Hospital Limerick, Dooradoyle, Limerick, Ireland.

E-mail: [email protected]

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First published: 02 August 2013
Citations: 46

Summary

This retrospective analysis assessed the response, safety and duration of response to standard dose rituximab 375 mg/m2 weekly for four weeks as therapy for patients with primary or secondary warm autoimmune haemolytic anaemia (WAIHA), who had failed initial treatment. Thirty-four patients received rituximab for WAIHA in seven centres in the Republic of Ireland. The overall response rate was 70·6% (24/34) with 26·5% (9/34) achieving a complete response (CR). The time to response was 1 month post-initiation of rituximab in 87·5% (21/24) and 3 months in 12·5% (3/24) of patients. The median duration of follow-up was 36 months (range 6–90 months). Of the patients who responded, 50% (12/24) relapsed during follow up with a median time to next treatment of 16·5 months (range 6–60 months). Three patients were re-treated with rituximab 375 mg/m2 weekly for four weeks at relapse and responded. There was a single episode of neutropenic sepsis. Rituximab is an effective and safe treatment for WAIHA but a significant number of patients will relapse in the first two years post treatment. Re-treatment was effective in a small number of patients, suggesting that intermittent pulse treatment or maintenance treatment may improve long-term response.

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