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A monocentric retrospective study comparing pulse cyclophosphamide therapy versus low dose rituximab in the treatment of refractory autoimmune hemolytic anemia in adults

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Abstract

This retrospective study aims at confirming the efficacy and safety of low dose rituximab and pulse cyclophosphamide in the treatment of refractory AIHA in adults and making comparison of the two. Forty-nine adult patients with refractory AIHA have been enrolled. Results showed low dose rituximab combined with steroid therapy (group B) got more CR (78.9 %, 15/19) compared to that in intermittent intravenous cyclophosphamide combined with steroid therapy (group A) (42.1 %, 8/19) (P = 0.04) at 6 months after treatment. The hemoglobin level in group B was higher than group A at the time point of 1 month (P = 0.02) after treatments. The RFS in group A was 87.9 % at 6 months and 82.7 % at 12 months, which were no significant difference with group B (91.1 % at 6 months and 86.0 % at 12 months) (P = 0.81). Both the two therapies were well tolerated with pulmonary infections as the most common side effects. In conclusion, low dose rituximab combined with steroid therapy presents to be a better choice in the treatment of refractory AIHA in adults comparing with pulse cyclophosphamide therapy.

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Acknowledgments

This work was supported by the National Natural Science Foundation of China (Grant Nos. 81570106, 81570111, 814000888, 81400085), the Tianjin Municipal Natural Science Foundation (Grant Nos. 14JCYBJC25400, 15JCYBJC24300).

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Correspondence to Rong Fu or Zonghong Shao.

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All authors declare that they have no conflict of interest.

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R. Fu and S. Yan contributed equally to this manuscript

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Fu, R., Yan, S., Wang, X. et al. A monocentric retrospective study comparing pulse cyclophosphamide therapy versus low dose rituximab in the treatment of refractory autoimmune hemolytic anemia in adults. Int J Hematol 104, 462–467 (2016). https://doi.org/10.1007/s12185-016-2056-5

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