Korean J Hematol.  2005 Jun;40(2):101-105. 10.5045/kjh.2005.40.2.101.

The Long Term Remission Effect of Rituximab in Two Patients with Autoimmune-associated Cytopenias that were Refractory to Standard Treatments

• Park SJ
• Han CW

• KMID: 2252344
• DOI: http://doi.org/10.5045/kjh.2005.40.2.101

Abstract

Rituximab, anti-CD20 chimeric monoclonal antibody directed against the CD20 antigen on B lymphocytes, induces a targeted B lymphocytes depletion in the aim of eradicating autoreactive clones in various autoimmune disorders. Because of its biological properties, it has been used as a treatment option for a variety of autoimmune diseases. We report two complicated patients: a 26-year-old female with steroid induced Cushing's syndrome and avascular necrosis of both femur heads, and a 56-year-old female with multiple spine compression fractures due to osteoporosis, diabetes mellitus and cataracts. They had long lasting, more than 10 years, lupus-associated hemolytic anemia and Evans syndrome, refractory to corticosteroids and immunosuppressive agents. The patients were treated with Rituximab, 375mg/m2 once weekly for 3 consecutive weeks. They showed a remarkable recovery about 5th week and have been free of transfusion after the treatment with Rituximab. Therapy was well tolerated, and no infectious complications occurred. They are still in complete remission at 20 and 4 months following the treatment, respectively. We suggest that Rituximab can be a valuable agent in the management of autoimmune cytopenias refractory to standard treatments.

Keyword

Rituximab; Anti-CD20; Autoimmune disease; Cytopenia

MeSH Terms

Adrenal Cortex Hormones
Adult
Anemia, Hemolytic
Antigens, CD20
Autoimmune Diseases
B-Lymphocytes
Cataract
Clone Cells
Cushing Syndrome
Diabetes Mellitus
Female
Femur Head
Fractures, Compression
Humans
Immunosuppressive Agents
Middle Aged
Necrosis
Osteoporosis
Spine
Rituximab
Adrenal Cortex Hormones
Antigens, CD20
Immunosuppressive Agents

Figure

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  Fig. 1. The response of hemoglobin and corrected reticulocyte count before and after Rituximab treatment. C sA, C yclosporine A; PD, Pednisolone; Dexa, Dxamethasone; p.o., Per oral; Hg, Hemoglobin; c-Reticulocyte, corrected- Reticulocyte; i.v., Intravenous.

• 

  Fig. 2. The response of platelet count before and after Rituximab treatment. PD, Prednisone; C sA, Cyclosporine A; IVIg, Intravenous immunoglobulin.

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