International Journal of Hematology

, Volume 78, Issue 4, pp 335–336 | Cite as

Rituximab Treatment for Relapsed Autoimmune Hemolytic Anemia in Evans Syndrome

  • Anat Galor
  • Timothy O’Brien
Case Report


A case is reported of idiopathic relapsed autoimmune hemolytic anemia successfully treated with rituximab.A 43-year-old white male patient with past medical history of Evans syndrome was found to have recurrent autoimmune hemolytic anemia. Previous treatments included steroids, splenectomy, intravenous immunoglobulin, plasmapheresis, staphylococcal Protein A immunoadsorption (Prosorba column), and chemotherapeutic agents (cytoxan and vincristine). Rituximab was given weekly at 375 mg/m2 for 4 doses.The drug was well tolerated and the patient remains in remission 9 months after completion of therapy.

Key words

Rituximab Immune hemolytic anemia 


  1. 1.
    Maloney D, Lopez A, White C, et al. IDEC-C2B8 (Rituximab) anti CD20 monoclonal antibody therapy in patients with relapsed low grade non-Hodgkin’s lymphoma.Blood. 1997;90:2188–2195.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Saleh M, Gutheil J, Moore M, et al. A pilot study of the anti-CD20 monoclonal antibody rituximab in patients with refractory immune thrombocytopenia.Semin Oncol. 2000;27:99–103.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Gupta N, Kavuru S, Patel D, et al. Rituximab-based chemotherapy for steroid-refractory autoimmune hemolytic anemia of chronic lymphocytic leukemia.Leukemia. 2002;16:2092–2095.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Cohen Y, Polliack A. Sustained complete remission of chronic refractory immune thrombocytopenic purpura (ITP) of 10 years duration after only two infusions of rituximab.Hematol J. 2002;3:61–62.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Mori A, Tamaru J-I, Sumi H, Kondo H. Beneficial effects of rituximab on primary cold agglutinin disease refractory to conventional therapy.Eur J Haematol. 2002;68:243–246.CrossRefPubMedGoogle Scholar
  6. 6.
    Cohen Y, Polliack A, Zelig O, Goldfarb A. Monotherapy with rituximab induces rapid remission of recurrent cold agglutininmediated hemolytic anemia in a patient with indolent lymphoplasmacytic lymphoma.Leuk Lymphoma. 2001;42:1405–1408.CrossRefPubMedGoogle Scholar
  7. 7.
    Motto DG, Williams JA, Boxer LA. Rituximab for refractory childhood autoimmune hemolytic anemia.Isr Med Assoc J. 2002;4:1006–1008.PubMedGoogle Scholar
  8. 8.
    Perrotta S, Locatelli F, La Manna A, Cennamo L, De Stefano P, Nobili B. Anti-CD20 monoclonal antibody (Rituximab) for lifethreatening autoimmune haemolytic anaemia in a patient with systemic lupus erythematosus.Br J Haematol. 2002;116:465–467.CrossRefPubMedGoogle Scholar
  9. 9.
    Zecca M, Nobili B, Ramenghi U, et al. Rituximab for the treatment of refractory autoimmune hemolytic anemia in children.Blood. 2003;101:3857–3861.CrossRefPubMedGoogle Scholar
  10. 10.
    Seipelt G, Koschmeider S, Hoelzer D. Effective treatment with rituximab in a patient with refractory prolymphocytoid transformed B-chronic lymphocytic leukemia and Evans syndrome.Annal Hematol. 2001;80:170–173.CrossRefGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2003

Authors and Affiliations

  1. 1.MetroHealth Medical CenterCWRU School of MedicineClevelandUSA

Personalised recommendations