• PDF / 170,377 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 96 Downloads / 162 Views

DOWNLOAD

REPORT

---

1 S

Lack of efficacy during treatment of autoimmune haemolytic anaemia: 3 case reports A retrospective case control study of 20 paediatric patients, who underwent allogenic haematopoietic stem cell transplantation (allo-HSCT) at the Children’s Hospital Colorado, USA, between June 2005 to March 2019, described 3 patients [sexes and ages not stated], who exhibited lack of efficacy during treatment with daclizumab, immune globulin, methylprednisolone, mycophenolate mofetil or rituximab for autoimmune haemolytic anaemia (AIHA) [not all dosages and routes stated]. Patient 1: The patient, who underwent allo-HSCT, developed AIHA 132 days following the transplantation. Consequently, the patient received first line therapy comprising methylprednisolone 2 mg/kg/day (with aim of tapering by 0.5 mg/kg/day every four to seven days until off, depending on the patient’s response), rituximab 375 mg/m2/dose scheduled to be taken weekly and daclizumab; however, no response to treatment was noted. The patient received 2 doses of rituximab. Thereafter, the patient received second-line therapy with plasmapheresis without response. Subsequently, the patient’s survival status decreased. Eventually, the patient died due to sepsis. Patient 10: The patient, who underwent allo-HSCT, developed AIHA 182 days following the transplantation. Consequently, the patient was treated with first line therapy comprising methylprednisolone and rituximab; however, only a partial response was noted. The patient received 17 doses of rituximab in total. Thereafter, the patient received second line therapy with mycophenolate mofetil without response. Subsequently, the patient was treated with third-line therapy comprising ofatumumab, daratumumab and sirolimus. The patient required 1095 days of therapy to show significant response. The patient remained alive. Patient 11: The patient, who underwent allo-HSCT, developed AIHA 182 days following the transplantation. Consequently, the patient was treated with first line therapy comprising methylprednisolone 2 mg/kg/day (with aim of tapering by 0.5 mg/kg/day every four to seven days until off, depending on the patient’s response) and IV immune globulin [immunoglobulin]; however, no response was noted. Subsequently, the patient received second-line therapy comprising rituximab, plasmapheresis and sirolimus; however only a partial response was noted. The patient received 12 doses of rituximab in total. The patient received third-line therapy with sirolimus. The patient required 334 days of therapy to show significant response. The patient remained alive. Koo J, et al. Autoimmune cytopenias following allogeneic hematopoietic stem cell transplant in pediatric patients: Response to therapy and late effects. Pediatric Blood and 803508042 Cancer 67: No. 9, Sep 2020. Available from: URL: http://doi.org/10.1002/pbc.28591

0114-9954/20/1826-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved

Reactions 17 Oct 2020 No. 1826