Low-Dose Rituximab for Autoimmune Hemolytic Anemia

Autoimmune hemolytic anemia (AIHA) is either primary (idiopathic) or secondary and is classified as either warm-reactive or cold-reactive antibody disease. Patients with warm-antibody disease usually respond to steroids and splenectomy, whereas those with cold agglutinin disease are often refractory to these modalities. Nonresponders occasionally benefit from standard doses of rituximab (375 mg/m² weekly for 4 weeks), but whether smaller doses in combination with steroids are capable of achieving remissions has not been evaluated.

To investigate this issue, researchers in Italy conducted a prospective, phase II study of low-dose rituximab (100 mg weekly for 4 weeks) plus prednisone (1 mg/kg/day for 30 days followed by a tapering schedule) in…