TY - JOUR
T1 - Rituximab is effective in the management of refractory autoimmune cytopenias occurring after allogeneic stem cell transplantation
AU - Raj, K
AU - Narayanan, S
AU - Augustson, Bradley
AU - Ho, A
AU - Mehta, P
AU - Duncan, N
AU - Tauro, S
AU - Mahendra, Premini
AU - Craddock, Charles
AU - Mufti, G
PY - 2004/11/29
Y1 - 2004/11/29
N2 - Autoimmune haemolytic anaemia (AIHA), immune thrombocytopenia (ITP) and autoimmune neutropenia (AIN) are well-recognised complications of allogeneic stem cell transplantation (SCT), but have previously only been reported in the context of myeloablative conditioning regimens. Management of AIHA, ITP or AIN occurring after allogeneic SCT is unsatisfactory since they frequently prove refractory to conventional therapies including splenectomy. As a consequence, autoimmune cytopenias occurring after allogeneic SCT are associated with substantial morbidity and mortality. We report four patients who developed AIHA or ITP after allogeneic transplantation -- three of which occurred after a reduced-intensity conditioning (RIC) regimen. All patients demonstrated a complete response to Rituximab, having failed to respond to conventional treatment including high-dose prednisolone and intravenous immunoglobulin (IVIg). We conclude that Rituximab can be a valuable agent in the management of autoimmune cytopenias occurring after allogeneic SCT and that autoimmune cytopenias may be a hitherto unrecognised complication of RIC regimens.
AB - Autoimmune haemolytic anaemia (AIHA), immune thrombocytopenia (ITP) and autoimmune neutropenia (AIN) are well-recognised complications of allogeneic stem cell transplantation (SCT), but have previously only been reported in the context of myeloablative conditioning regimens. Management of AIHA, ITP or AIN occurring after allogeneic SCT is unsatisfactory since they frequently prove refractory to conventional therapies including splenectomy. As a consequence, autoimmune cytopenias occurring after allogeneic SCT are associated with substantial morbidity and mortality. We report four patients who developed AIHA or ITP after allogeneic transplantation -- three of which occurred after a reduced-intensity conditioning (RIC) regimen. All patients demonstrated a complete response to Rituximab, having failed to respond to conventional treatment including high-dose prednisolone and intravenous immunoglobulin (IVIg). We conclude that Rituximab can be a valuable agent in the management of autoimmune cytopenias occurring after allogeneic SCT and that autoimmune cytopenias may be a hitherto unrecognised complication of RIC regimens.
UR - http://www.scopus.com/inward/record.url?scp=13944271921&partnerID=8YFLogxK
U2 - 10.1038/sj.bmt.1704705
DO - 10.1038/sj.bmt.1704705
M3 - Article
C2 - 15568036
VL - 35
SP - 299
EP - 301
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
ER -