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Blood, 15 April 2004, Vol. 103, No. 8, pp. 2925-2928. Prepublished online as a Blood First Edition Paper on December 30, 2003; DOI 10.1182/blood-2003-10-3597. This Article Full Text (PDF) All Versions of this Article: 2003-10-3597v1 103/8/2925    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 Berentsen, S. Articles by Tjonnfjord, G. E Search for Related Content PubMed PubMed Citation Articles by Berentsen, S. Articles by Tjonnfjord, G. E Social Bookmarking                   What's this? Submitted October 21, 2003 Accepted December 20, 2003 Rituximab for primary chronic cold agglutinin disease: a prospective study of 37 courses of therapy in 27 patients Sigbjorn Berentsen*, Elling Ulvestad, Bjorn Tore Gjertsen, Henrik Hjorth-Hansen, Ruth Langholm, Havar Knutsen, Waleed Ghanima, Fuad Victor Shammas, and Geir E Tjonnfjord Dept. of Medicine, Haugesund Hospital, Haugesund, Norway; Dept. of Medicine, University of Bergen, Bergen, Norway Dept. of Microbiology and Immunology, Haukeland University Hospital, Bergen, Norway Dept. of Medicine, Haukeland University Hospital, Bergen, Norway Dept. of Medicine, St Olav University Hospital, Trondheim, Norway Dept. of Pathology, The Norwegian Radium Hospital, Oslo, Norway Dept. of Medicine, Akershus University Hospital, Lorenskog, Norway Dept. of Medicine, Ostfold Hospital Fredrikstad, Fredrikstad, Norway Dept. of Hematology and Oncology, Rogaland Central Hospital, Stavanger, Norway Dept. of Medicine, The National Hospital, Oslo, Norway * Corresponding author; email: s.beren{at}online.no. Conventional therapies for primary chronic cold agglutinin disease (CAD) are ineffective, but remissions after treatment with the anti-CD20 antibody rituximab have been described in a small, prospective trial and some case reports. In this study we report on 37 courses of rituximab administered prospectively to 27 patients. Fourteen of 27 patients responded to their first course of rituximab, and 6 of 10 responded to re-treatment. In both groups combined, responses were achieved after 20 of 37 courses, giving an overall response rate of 54%. We observed 1 complete and 19 partial responses. Two non-responders and 3 relapsed patients received second-line therapy with interferon- combined with a new course of rituximab, and 1 non-responder and 2 relapsed patients achieved partial response. Responders achieved a median increase in hemoglobin levels of 4.0 g/dL. Median time to response was 1.5 months and median observed response duration 11 months. We conclude that rituximab is an effective and well-tolerated therapy for CAD. Histological and flowcytometric findings suggest that some of the effect may be mediated by other mechanisms than elimination of clonal lymphocytes. We were unable to predict response from the hematological, immunological, or histological parameters prior to therapy. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: B. Granel, P. Rossi, F. Bernard, I. Dettori, R. Costello, A. L. Demoux, D. Bagneres, P. Lafforgue, and Y. Frances Good outcome after rituximab treatment for a mixed warm and cold autoimmune haemolytic anaemia BMJ Case Reports, March 6, 2009; 2009(mar05_2): bcr0920080857 - bcr0920080857. [Abstract] [Full Text] 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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