Abstract |
Autoimmune hemolytic anemia (AIHA) is a heterogeneous disease usually classified according to the thermal range of the autoantibody in warm, cold and mixed forms. The treatment of AIHA is still not evidence-based. Corticosteroids are the first-line therapy for warm AIHA. For refractory/relapsed cases, the choice is between splenectomy (effective in ∼70% cases but with a presumed cure rate of 20%) and rituximab (effective in ∼70-80% of cases), which is becoming the preferred second-line treatment, and thereafter any of the immunosuppressive drugs ( azathioprine, cyclophosphamide, cyclosporin, mycophenolate mofetil). Additional therapies are intravenous immunoglobulins and danazol. For severe or refractory cases, last option treatments are plasma-exchange, high-dose cyclophosphamide and alemtuzumab. As regards cold agglutinin disease, rituximab is now recommended as first-line treatment.
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Authors | Wilma Barcellini |
Journal | Expert review of hematology
(Expert Rev Hematol)
Vol. 8
Issue 5
Pg. 681-91
(Oct 2015)
ISSN: 1747-4094 [Electronic] England |
PMID | 26343892
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
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Chemical References |
- Adrenal Cortex Hormones
- Immunologic Factors
- Immunosuppressive Agents
- Rituximab
- Cyclophosphamide
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Topics |
- Adrenal Cortex Hormones
(administration & dosage, therapeutic use)
- Anemia, Hemolytic, Autoimmune
(diagnosis, therapy)
- Cyclophosphamide
(administration & dosage, therapeutic use)
- Humans
- Immunologic Factors
(administration & dosage, therapeutic use)
- Immunosuppressive Agents
(administration & dosage, therapeutic use)
- Rituximab
(administration & dosage, therapeutic use)
- Splenectomy
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