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Prepublished online as a Blood First Edition Paper on April 17, 2002; DOI 10.1182/blood-2002-01-0087.

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Submitted January 14, 2002
Accepted March 1, 2002

High-dose cyclophosphamide for refractory autoimmune hemolytic anemia

Victor M Moyo, B. D Smith, Isadore Brodsky, Pamela Crilley, Richard J Jones, and Robert A Brodsky*

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Johns Hopkins, Baltimore, MD, USA
Medicine, MCP Hahnemann, Philadelphia, PA, USA

* Corresponding author; email: rbrodsky{at}jhmi.edu.

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 (50mg/kg/d for 4 days) who had failed a median of 3 (range; 1-7) other treatments. The median hemoglobin (HB) before treatment was 6.7 (range; 5-10) g/dl. The median time to reach an absolute neutrophil count (ANC) >= 500/µl was 16 (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 (range 4-29) months. Three patients achieved and continue in partial remission (HB >= 10 g/dl, without transfusion support). High-dose cyclophosphamide was well tolerated and induced durable remissions in patients with severe refractory autoimmune hemolytic anemia.


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M. Petri and R. Brodsky
High-Dose Cyclophosphamide and Stem Cell Transplantation for Refractory Systemic Lupus Erythematosus
JAMA, February 1, 2006; 295(5): 559 - 560.
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