Pharmacologic treatment options for relapsed or refractory cold agglutinin disease from case series
| Treatment . | Initial dose . | OR, % . | Median time To response (range) . | Median response duration (range) . | Relapse rate (at 1-2 y), % . | Comments . | Reference . |
|---|---|---|---|---|---|---|---|
| Chlorambucil | 4-20 mg orally once a day | 16-46 | NA | 11 mo | NA | Included newly diagnosed and previously treated patients (N = 19-37) | 64, 65 |
| Cyclophosphamide | 50-150 mg orally once a day | ||||||
| Rituximab | 375 mg/m2 IV every week × 4 wk | 45-54 | 1.5 mo (1-2) | 10 mo (8-27) | 50-83 | Included newly diagnosed and previously treated patients (N = 20-32) | 64, 67, 68 |
| Rituximab + prednisone | Rituximab: 100 mg IV every week × 4 wk; Prednisone: 1 mg/kg per day orally × 30 d, then taper | 56 | 2 wk | NA | 33 | Included newly diagnosed and previously treated patients (N = 19) | 35 |
| Rituximab + fludarabine | Rituximab: 375 mg/m2 IV every 4 wk; Fludarabine: 40 mg/m2 orally on days 1-5 every 4 wk; both × 4 cycles | 76 | 4 mo | >66 mo (3-66) | 23 | Grade 3-4 hematologic toxicities in 41% (N = 29) | 73 |
| Treatment . | Initial dose . | OR, % . | Median time To response (range) . | Median response duration (range) . | Relapse rate (at 1-2 y), % . | Comments . | Reference . |
|---|---|---|---|---|---|---|---|
| Chlorambucil | 4-20 mg orally once a day | 16-46 | NA | 11 mo | NA | Included newly diagnosed and previously treated patients (N = 19-37) | 64, 65 |
| Cyclophosphamide | 50-150 mg orally once a day | ||||||
| Rituximab | 375 mg/m2 IV every week × 4 wk | 45-54 | 1.5 mo (1-2) | 10 mo (8-27) | 50-83 | Included newly diagnosed and previously treated patients (N = 20-32) | 64, 67, 68 |
| Rituximab + prednisone | Rituximab: 100 mg IV every week × 4 wk; Prednisone: 1 mg/kg per day orally × 30 d, then taper | 56 | 2 wk | NA | 33 | Included newly diagnosed and previously treated patients (N = 19) | 35 |
| Rituximab + fludarabine | Rituximab: 375 mg/m2 IV every 4 wk; Fludarabine: 40 mg/m2 orally on days 1-5 every 4 wk; both × 4 cycles | 76 | 4 mo | >66 mo (3-66) | 23 | Grade 3-4 hematologic toxicities in 41% (N = 29) | 73 |
NA, not available.