Abstract
A 30-year-old Japanese woman who underwent nonmyeloablative stem cell transplantation from her HLA-matched sister developed autoimmune hemolytic anemia (AIHA). There was proliferation of EBV-DNA in her peripheral blood and monoclonal gammopathy, both predictive factors of post-transplant lymphoproliferative disorder (PTLD). As conventional immunosuppressive therapy for AIHA could lead to overt PTLD, we decided to give her rituximab 375 mg/m2 once weekly for a total of four doses. After this therapy, both her AIHA and monoclonal gammopathy were resolved and EBV-DNA became undetectable. Rituximab therapy deserves consideration for treatment of post-allogeneic stem cell transplant patients with AIHA, especially for patients who cannot be given immunosuppressive therapy.
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Acknowledgments
We are grateful to S. Yoshida for performing quantitive real-time PCR assays of EBV, and to T. Kamesaki and E. Kajii for measuring red blood cell-associated IgG. We thank M. Kitayama and I. Sato for technical assistance.
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Endo, T., Nakao, S., Koizumi, K. et al. Successful treatment with rituximab for autoimmune hemolytic anemia concomitant with proliferation of Epstein-Barr virus and monoclonal gammopathy in a post-nonmyeloablative stem cell transplant patient. Ann Hematol 83, 114–116 (2004). https://doi.org/10.1007/s00277-003-0740-z
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DOI: https://doi.org/10.1007/s00277-003-0740-z