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Autologous peripheral blood stem cell transplantation and anti-B-cell directed immunotherapy for refractory auto-immune haemolytic anaemia

Lookup NU author(s): Professor Hermann Josef Vormoor

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Abstract

We report the clinical course of a 6.5-year-old boy with refractory auto-immune haemolytic anaemia. Due to failure of conventional immunosuppressive therapy, an autologous peripheral blood stem cell transplantation was performed. The conditioning regimen consisted of cyclophosphamide and anti-thymocyte globulin. The patient was reinfused with 2.6 x 10(6) CD34 positive selected, B- and T-cell-depleted peripheral blood stem cells per kg body weight. He showed a partial response with a reduced demand for red blood cell transfusions. However, due to persistence of the haemolytic process he was started on rituximab therapy on day +40 post-transplant. Following two doses of rituximab, the patient improved rapidly and developed a sustained complete response. After 10 months, haemolysis recurred and responded again to rituximab therapy without the necessity for red blood cell transfusions. 15 months after initial antibody treatment, however, the patient developed a second relapse which was now refractory to rituximab therapy although CD20+ B-lymphocytes were cleared from the peripheral blood. CONCLUSION: Our case report suggests that rituximab and autologous peripheral blood stem cell transplantation are important though not curative elements in the treatment of patients with severe auto-immune haemolytic anaemia who are refractory to conventional immunosuppressive therapy.

Publication metadata

Author(s): Seeliger S, Baumann M, Mohr M, Jürgens H, Frosch M, Vormoor J

Publication type: Article

Publication status: Published

Journal: European Journal of Pediatrics

Year: 2001

Volume: 160

Issue: 8

Pages: 492-496

Print publication date: 01/08/2001

ISSN (print): 0340-6199

ISSN (electronic): 1432-1076

URL: http://dx.doi.org/10.1007/s004310100778

DOI: 10.1007/s004310100778

Notes: 0340-6199 (Print) Case Reports Journal Article

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