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Blood, 15 June 2001, Vol. 97, No. 12, pp. 3995-3997
BRIEF REPORT
Anti-CD20 monoclonal antibody for the treatment of severe,
immune-mediated, pure red cell aplasia and hemolytic anemia
Marco Zecca,
Piero De
Stefano,
Bruno Nobili, and
Franco Locatelli
From Pediatric Hematology/Oncology, IRCCS
Policlinico San Matteo, University of Pavia, Italy, and the Department
of Pediatrics, University of Naples, Italy.
Immune-mediated, acquired pure red cell aplasia (PRCA) is a
rare disorder frequently associated with other autoimmune phenomena. Conventional immunosuppressive treatment is often unsatisfactory. Rituximab is a monoclonal antibody against the CD20 antigen, highly effective for in vivo B-cell depletion. An 18-month-old girl
with both severe PRCA and autoimmune hemolytic anemia, refractory to immunosuppressive treatment, received 2 doses of rituximab, 375 mg/m2 per week. The drug was well tolerated. After
anti-CD20 therapy, substitutive treatment with intravenous
immunoglobulin was started. The treatment resulted in marked depletion
of B cells; a striking rise in reticulocyte count ensued, with
increasing hemoglobin levels, finally leading to transfusion
independence. The child is now 5 months off-therapy, with normal
hemoglobin and reticulocyte levels. This case suggests a role of
anti-CD20 monoclonal antibody for treatment of patients with
antibody-mediated hematologic disorders.
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