Rituximab in chronic cold agglutinin disease: a prospective study of 20 patients

Chronic cold agglutinin disease (CAD) is an acquired autoimmune hemolytic anemia. Previous therapeutic modalities, including alkylating cytostatics, interferon and prednisolone, have been disappointing. However, several case reports and small-scaled studies have demonstrated promising results after...

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Bibliographic Details
Published in:Leukemia & lymphoma 2006-02, Vol.47 (2), p.253-260
Main Authors: Schöllkopf, Claudia, Kjeldsen, Lars, Bjerrum, Ole Weiss, Mourits-Andersen, Hans Torben, Nielsen, Johan Lanng, Christensen, Bjarne Egelund, Jensen, Bjarne Anker, Pedersen, Bjarne Bach, Taaning, Ellen Birkerod, Klausen, Tobias Wirenfeldt, Birgens, Henrik
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Anemia, Hemolytic, Autoimmune - drug therapy
Antibodies, Monoclonal - adverse effects
Antibodies, Monoclonal - therapeutic use
Antibodies, Monoclonal, Murine-Derived
Autoimmune hemolytic anemia
chronic cold agglutinin disease
Chronic Disease
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
Humans
Immunologic Factors - adverse effects
Immunologic Factors - therapeutic use
Male
Middle Aged
phase II study
Prospective Studies
Recurrence
Remission Induction
Rituximab
treatment
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Summary:Chronic cold agglutinin disease (CAD) is an acquired autoimmune hemolytic anemia. Previous therapeutic modalities, including alkylating cytostatics, interferon and prednisolone, have been disappointing. However, several case reports and small-scaled studies have demonstrated promising results after treatment with rituximab. We performed a phase II multicentre trial to investigate the effect of rituximab in CAD, including 20 patients studied from October 2002 until April 2003. Thirteen patients had idiopathic CAD and seven patients had CAD associated with a malignant B-cell lymphoproliferative disease. Rituximab was given in doses of 375 mg m2 at days 1, 8, 15 and 22. Sixteen patients were followed up for at least 48 weeks. Four patients were excluded after 8, 16, 23 and 28 weeks for reasons unrelated to CAD. Nine patients (45%) responded to the treatment, one with complete response (CR), and eight with partial response. Eight patients relapsed, one patient was still in remission at the end of follow-up. There were no serious rituximab-related side-effects. Our study confirms previous findings of a favourable effect of rituximab in patients with CAD. However, few patients will obtain CR and, in most patients, the effect will be transient.
ISSN:1042-8194
1029-2403
DOI:10.1080/10428190500286481