Abstract | INTRODUCTION: CASE REPORT: A 57-year- old man affected by CLL, presented with fatigue, dyspnoea, tachycardia and jaundice. His physical examination revealed overt jaundice, hepato- and splenomegaly, and enlargement of lymph nodes in all superficial sites. The blood chemistry showed severe anemia (Hb value 3.9 g/dL), high white blood cell count (89 x 10(9)/L), altered hemolysis markers and direct antiglobulin test (DAT) was positive for both complement and IgG. The patient failed to respond to both a 4-day course of high-dose dexamethasone IV (40 mg/day) and intravenous immunoglobulin ( IVIg) (1 g/kg/day x 2 days). Thus, a schedule containing rituximab (375 mg/m(2) day +1), cyclophosphamide (750 mg/m(2) day +2) and prednisone (60 mg/m(2) from day +1 to day +7) (R-CP) were administered. Four cycles, repeated every 4 weeks, were administered. After 4 days from the infusion of this schedule, the patient showed a marked reduction of the lymphocytosis, and the hemoglobin level started to increase. No rituximab-related side effects were recorded. At the end of treatment DAT became negative and patient achieved a nodular Partial Remission (nPR). CONCLUSION: Our data showed the safety and efficacy of a rituximab-containing regimen in a life-threatening CLL-related AIHA, refractory to steroid and IVIg therapy. This schedule has allowed the patient to obtain a prompt and dramatic rise in hemoglobin level and a response to both AIHA and CLL.
|
Authors | Massimo Gentile, Eugenio Lucia, Caterina Iorio, Ernesto Vigna, Carla Mazzone, Rosellina Morelli, Maria Grazia Bisconte, Carlo Gentile, Fortunato Morabito |
Journal | Cancer chemotherapy and pharmacology
(Cancer Chemother Pharmacol)
Vol. 62
Issue 4
Pg. 741-3
(Sep 2008)
ISSN: 0344-5704 [Print] Germany |
PMID | 18064461
(Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Antibodies, Monoclonal
- Antibodies, Monoclonal, Murine-Derived
- Glucocorticoids
- Immunoglobulins, Intravenous
- Immunologic Factors
- Rituximab
|
Topics |
- Anemia, Hemolytic, Autoimmune
(drug therapy, etiology, pathology)
- Antibodies, Monoclonal
(therapeutic use)
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Glucocorticoids
(therapeutic use)
- Humans
- Immunoglobulins, Intravenous
(therapeutic use)
- Immunologic Factors
(therapeutic use)
- Leukemia, Lymphocytic, Chronic, B-Cell
(complications, drug therapy, pathology)
- Male
- Middle Aged
- Rituximab
- Treatment Failure
- Treatment Outcome
|