Pharmacologic treatment options for relapsed or refractory warm autoimmune hemolytic anemia from a case series
| Treatment . | Initial dose(s) . | OR, % . | Median time to response (range) . | Median response duration (range) . | Relapse rate (at 1-2 y), % . | Comments . | Reference . |
|---|---|---|---|---|---|---|---|
| Azathioprine | 2-4 mg/kg orally once a day | 50-70 | NA | 11 mo (4-36) | 60 | N = 9-31 | 19, 24, 36, 37 |
| Cyclophosphamide (low dose) | 1-2 mg/kg orally once a day; or 50-150 mg orally once a day | 50-70 | NA | 11 mo (4-36) | 50 | N = 7-40 | 19, 24, 26, 37 |
| Cyclophosphamide (high dose) | 50 mg/kg IV days 1-4 with mesna and granulocyte colony stimulating factor rescue; or 1000 mg IV every 4 wk × 4 | 100 | 3 wk; 82% at 4 mo | 15 mo (4-29) | 0 | For the 50 mg/kg dose, 40% hospitalization due to complications (N = 9-17) | 38, 39 |
| Cyclosporine | 2.5 mg/kg orally twice a day | 60 | NA | 11 mo (4-36) | NA | Maintain serum level 200-400 ng/mL (N = 12) | 24 |
| Danazol | 200 mg orally 3-4 times daily | 60-80 | NA | 18 mo (7-77) | 30-75 | Maintenance dose 200-400 mg/day (N = 15-22) | 8, 40, 41 |
| Mycophenolate | 500-1000 mg orally twice a day | 25-70 | 5 mo (1-9) | 11 mo (4-36) | NA | N = 3-4 | 19, 24, 42 |
| Rituximab | 375 mg/m2 IV every week × 4; or 100 mg IV every week × 2-4 | 70-90 | 2 wk (1-12) | 20 mo (9-60) | 20-50 | N = 25-74 | 19, 24, 44 |
| Treatment . | Initial dose(s) . | OR, % . | Median time to response (range) . | Median response duration (range) . | Relapse rate (at 1-2 y), % . | Comments . | Reference . |
|---|---|---|---|---|---|---|---|
| Azathioprine | 2-4 mg/kg orally once a day | 50-70 | NA | 11 mo (4-36) | 60 | N = 9-31 | 19, 24, 36, 37 |
| Cyclophosphamide (low dose) | 1-2 mg/kg orally once a day; or 50-150 mg orally once a day | 50-70 | NA | 11 mo (4-36) | 50 | N = 7-40 | 19, 24, 26, 37 |
| Cyclophosphamide (high dose) | 50 mg/kg IV days 1-4 with mesna and granulocyte colony stimulating factor rescue; or 1000 mg IV every 4 wk × 4 | 100 | 3 wk; 82% at 4 mo | 15 mo (4-29) | 0 | For the 50 mg/kg dose, 40% hospitalization due to complications (N = 9-17) | 38, 39 |
| Cyclosporine | 2.5 mg/kg orally twice a day | 60 | NA | 11 mo (4-36) | NA | Maintain serum level 200-400 ng/mL (N = 12) | 24 |
| Danazol | 200 mg orally 3-4 times daily | 60-80 | NA | 18 mo (7-77) | 30-75 | Maintenance dose 200-400 mg/day (N = 15-22) | 8, 40, 41 |
| Mycophenolate | 500-1000 mg orally twice a day | 25-70 | 5 mo (1-9) | 11 mo (4-36) | NA | N = 3-4 | 19, 24, 42 |
| Rituximab | 375 mg/m2 IV every week × 4; or 100 mg IV every week × 2-4 | 70-90 | 2 wk (1-12) | 20 mo (9-60) | 20-50 | N = 25-74 | 19, 24, 44 |
NA, not available.