Blood, 15 July 2002, Vol. 100, No. 2, pp. 704-706
BRIEF REPORT
High-dose cyclophosphamide for refractory autoimmune
hemolytic anemia
Victor M. Moyo,
Douglas Smith,
Isadore Brodsky,
Pamela Crilley,
Richard J. Jones, and
Robert A. Brodsky
From the Sidney Kimmel Comprehensive Cancer Center at
Johns Hopkins, Baltimore, MD; and Medical College of Pennsylvania,
Hahnemann University, Philadelphia, PA.
High-dose cyclophosphamide, without stem cell rescue, has been used
successfully to treat aplastic anemia and other autoimmune disorders.
To determine the safety and efficacy of high-dose cyclophosphamide among patients with severe refractory autoimmune hemolytic anemia, we
treated 9 patients with cyclophosphamide (50 mg · kg
1 · d1 for 4 days) who had
failed a median of 3 (range, 1-7) other treatments. The median
hemoglobin before treatment was 6.7 g/dL (range, 5-10 g/dL). The median
time to reach an absolute neutrophil count of 500/µL or greater was
16 days (range, 12-18 days). Six patients achieved complete remission
(normal untransfused hemoglobin for age and sex), and none have
relapsed after a median follow-up of 15 months (range, 4-29 months).
Three patients achieved and continue in partial remission (hemoglobin
at least 10 g/dL without transfusion support). High-dose
cyclophosphamide was well tolerated and induced durable remissions in
patients with severe refractory autoimmune hemolytic anemia.
