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Prepublished online as a Blood First Edition Paper on January 16, 2003; DOI 10.1182/blood-2002-11-3547. This Article Full Text (PDF) All Versions of this Article: 2002-11-3547v1 101/10/3857    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Zecca, M. Articles by Locatelli, F. W Search for Related Content PubMed PubMed Citation Articles by Zecca, M. Articles by Locatelli, F. W Social Bookmarking                   What's this? Submitted November 25, 2002 Accepted January 8, 2003 Rituximab for the treatment of refractory autoimmune hemolytic anemia in children Marco Zecca, Bruno Nobili, Ugo Ramenghi, Silverio Perrotta, Giovanni Amendola, Pasquale Rosito, Momcilo Jankovic, Paolo Pierani, Piero De Stefano, Mario Regazzi Bonora, and Franco W Locatelli* Oncoematologia Pediatrica, IRCCS Policlinico San Matteo, Pavia, Italy Clinica Pediatrica I, Seconda Universita' degli Studi, Naples, Italy Clinica Pediatrica, Universita' di Torino, Ospedale Regina Margherita, Torino, Italy Ematologia-Oncologia Pediatrica, Ospedale di Nocera Inferiore, Nocera Inferiore, Italy Clinica Pediatrica, Universita' di Bologna, Policlinico Sant'Orsola, Bologna, Italy Clinica Pediatrica, Universita' di Milano Bicocca, Ospedale Nuovo San Gerardo, Monza, Italy Clinica Pediatrica, Universita' di Ancona, Ancona, Italy Farmacologia Clinica, IRCCS Policlinico San Matteo, Pavia, Italy * Corresponding author; email: f.locatelli{at}smatteo.pv.it. Autoimmune hemolytic anemia (AIHA) in children is sometimes characterized by a severe course, requiring prolonged administration of immunosuppressive therapy. Rituximab is able to cause selective in vivo destruction of B lymphocytes, with abrogation of antibody production. We have evaluated in a prospective study the use of Rituximab for the treatment of AIHA resistant to conventional treatment. Fifteen children with AIHA were given Rituximab, 375 mg/m2/dose for a median of 3 weekly doses. All patients had previously received 2 or more courses of immunosuppressive therapy; 2 patients had been splenectomized. After completing treatment, all children received intravenous immunoglobulin for 6 months. Treatment was well tolerated. With a median follow-up of 13 months, 13 patients (87%) responded, while 2 patients did not show any improvement. Median Hb levels increased from 7.7 g/dL to a 2-month post-treatment level of 11.8 g/dL (P < 0.001). Median absolute reticulocyte counts decreased from 236 to 109 x 109/L (P < 0.01). An increase in platelet count was observed in patients with concomitant thrombocytopenia (Evans syndrome). Three responder patients relapsed, 7, 8 and 10 months after Rituximab infusion, respectively. All 3 children received a second course of Rituximab achieving again disease remission. Our data indicate that Rituximab is both safe and effective in reducing or even abolishing hemolysis in children with AIHA and that a sustained response can be achieved in the majority of cases. Disease recurrence may occur, but a second treatment course may be successful in controlling the disease. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: F. Zaja, M. L. Battista, M. T. Pirrotta, S. Palmieri, M. Montagna, N. Vianelli, L. Marin, M. Cavallin, M. Bocchia, M. Defina, et al. 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