Progression of CD20 monoclonal antibody in the treatment of autoimmune hemolytic anemia_West China Medical Journal

Authors：

GUAN Jing , YANG Jin ,  XING Limin

Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, P. R. China;

Corresponding author：

XING Limin, Email: xinglm2019@tmu.edu.cn

Keywords：

Autoimmune hemolytic anemia; Anti-CD20 monoclonal antibody; Rituximab

DOI：

10.7507/1002-0179.202108096

Video：

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Autoimmune hemolytic anemia (AIHA) is an autoimmune disease in which the life span of red blood cells is shortened by red blood cell autoantibodies. Due to immune intolerance and abnormal immune regulation, the hyperfunction of B lymphocytes produces too many red blood cell autoantibodies. Anti-CD20 monoclonal antibody is a second-line drug for warm antibody AIHA and first-line drug for cold antibody AIHA by reducing B lymphocytes. At present, the optimal dose of anti-CD20 monoclonal antibody in the treatment of AIHA has not been determined. There are no reports on the treatment of primary AIHA with second- or third-generation anti-CD20 monoclonal antibodies.

Citation： GUAN Jing, YANG Jin, XING Limin. Progression of CD20 monoclonal antibody in the treatment of autoimmune hemolytic anemia. West China Medical Journal, 2021, 36(10): 1439-1443. doi: 10.7507/1002-0179.202108096 Copy

1.	Peñalver FJ, Alvarez-Larrán A, Díez-Martin JL, et al. Rituximab is an effective and safe therapeutic alternative in adults with refractory and severe autoimmune hemolytic anemia. Ann Hematol, 2010, 89(11): 1073-1080.
2.	Barcellini W, Fattizzo B, Zaninoni A. Current and emerging treatment options for autoimmune hemolytic anemia. Expert Rev Clin Immunol, 2018, 14(10): 857-872.
3.	Makis A, Kanta Z, Kalogeropoulos D, et al. Anti-CD20 treatment of autoimmune hemolytic anemia refractory to corticosteroids and azathioprine: a pediatric case report and mini review. Case Rep Hematol, 2018, 2018: 8471073.
4.	Valent P, Lechner K. Diagnosis and treatment of autoimmune haemolytic anaemias in adults: a clinical review. Wien Klin Wochenschr, 2008, 120(5/6): 136-151.
5.	Maung SW, Leahy M, O’Leary HM, et al. A multi-centre retrospective study of rituximab use in the treatment of relapsed or resistant warm autoimmune haemolytic anaemia. Br J Haematol, 2013, 163(1): 118-122.
6.	Salles G, Barrett M, Foà R, et al. Rituximab in B-cell hematologic malignancies: a review of 20 years of clinical experience. Adv Ther, 2017, 34(10): 2232-2273.
7.	Iskandar A, Hwang A, Dasanu CA. Severe warm-antibody autoimmune hemolytic anemia due to multicentric Castleman disease: responding to rituximab. J Oncol Pharm Pract, 2019, 25(8): 2016-2018.
8.	Kaegi C, Wuest B, Schreiner J, et al. Systematic review of safety and efficacy of rituximab in treating immune-mediated disorders. Front Immunol, 2019, 10: 1990.
9.	Pavanello F, Zucca E, Ghielmini M. Rituximab: 13 open questions after 20 years of clinical use. Cancer Treat Rev, 2017, 53: 38-46.
10.	Fu R, Yan S, Wang X, et al. A monocentric retrospective study comparing pulse cyclophosphamide therapy versus low dose rituximab in the treatment of refractory autoimmune hemolytic anemia in adults. Int J Hematol, 2016, 104(4): 462-467.
11.	Quinquenel A, Willekens C, Dupuis J, et al. Bendamustine and rituximab combination in the management of chronic lymphocytic leukemia-associated autoimmune hemolytic anemia: a multicentric retrospective study of the French CLL intergroup (GCFLLC/MW and GOELAMS). Am J Hematol, 2015, 90(3): 204-207.
12.	Byrd JC, Murphy T, Howard RS, et al. Rituximab using a thrice weekly dosing schedule in B-cell chronic lymphocytic leukemia and small lymphocytic lymphoma demonstrates clinical activity and acceptable toxicity. J Clin Oncol, 2001, 19(8): 2153-2164.
13.	Coiffier B, Haioun C, Ketterer N, et al. Rituximab (anti-CD20 monoclonal antibody) for the treatment of patients with relapsing or refractory aggressive lymphoma: a multicenter phase Ⅱ study. Blood, 1998, 92(6): 1927-1932.
14.	Michel M, Terriou L, Roudot-Thoraval F, et al. A randomized and double-blind controlled trial evaluating the safety and efficacy of rituximab for warm auto-immune hemolytic anemia in adults (the RAIHA study). Am J Hematol, 2017, 92(1): 23-27.
15.	Birgens H, Frederiksen H, Hasselbalch HC, et al. A phase Ⅲ randomized trial comparing glucocorticoid monotherapy versus glucocorticoid and rituximab in patients with autoimmune haemolytic anaemia. Br J Haematol, 2013, 163(3): 393-399.
16.	Jaime-Pérez JC, Aguilar-Calderón P, Salazar-Cavazos L, et al. Treatment of autoimmune hemolytic anemia: real world data from a reference center in Mexico. Blood Res, 2019, 54(2): 131-136.
17.	Barcellini W, Zaja F, Zaninoni A, et al. Sustained response to low-dose rituximab in idiopathic autoimmune hemolytic anemia. Eur J Haematol, 2013, 91(6): 546-551.
18.	Jäger U, Barcellini W, Broome CM, et al. Diagnosis and treatment of autoimmune hemolytic anemia in adults: recommendations from the First International Consensus Meeting. Blood Rev, 2020, 41: 100648.
19.	Barcellini W, Zaninoni A, Giannotta JA, et al. New insights in autoimmune hemolytic anemia: from pathogenesis to therapy stage 1. J Clin Med, 2020, 9(12): 3859.
20.	Berentsen S, Randen U, Vågan AM, et al. High response rate and durable remissions following fludarabine and rituximab combination therapy for chronic cold agglutinin disease. Blood, 2010, 116(17): 3180-3184.
21.	Berentsen S, Randen U, Oksman M, et al. Bendamustine plus rituximab for chronic cold agglutinin disease: results of a Nordic prospective multicenter trial. Blood, 2017, 130(4): 537-541.
22.	Barcellini W, Fattizzo B, Cortelezzi A. Autoimmune hemolytic anemia, autoimmune neutropenia and aplastic anemia in the elderly. Eur J Intern Med, 2018, 58: 77-83.
23.	Laribi K, Bolle D, Ghnaya H, et al. Rituximab is an effective and safe treatment of relapse in elderly patients with resistant warm AIHA. Ann Hematol, 2016, 95(5): 765-769.
24.	Zecca M, Nobili B, Ramenghi U, et al. Rituximab for the treatment of refractory autoimmune hemolytic anemia in children. Blood, 2003, 101(10): 3857-3861.
25.	Gupta N, Sharma S, Seth T, et al. Rituximab in steroid refractory autoimmune hemolytic anemia. Indian J Pediatr, 2012, 79(6): 803-805.
26.	Teachey DT, Lambert MP. Diagnosis and management of autoimmune cytopenias in childhood. Pediatr Clin North Am, 2013, 60(6): 1489-1511.
27.	Rao A, Kelly M, Musselman M, et al. Safety, efficacy, and immune reconstitution after rituximab therapy in pediatric patients with chronic or refractory hematologic autoimmune cytopenias. Pediatr Blood Cancer, 2008, 50(4): 822-825.
28.	Svahn J, Fioredda F, Calvillo M, et al. Rituximab-based immunosuppression for autoimmune haemolytic anaemia in infants. Br J Haematol, 2009, 145(1): 96-100.
29.	Ansari S, Tashvighi M, Darbandi B, et al. Rituximab for child with chronic relapsing autoimmune hemolytic anemia. Pediatr Hematol Oncol, 2011, 28(2): 164-166.
30.	Ducassou S, Leverger G, Fernandes H, et al. Benefits of rituximab as a second-line treatment for autoimmune haemolytic anaemia in children: a prospective French cohort study. Br J Haematol, 2017, 177(5): 751-758.
31.	Wang H, Yan S, Liu H, et al. Infection risk in autoimmune hematological disorders with low-dose rituximab treatment. J Clin Lab Anal, 2020, 34(10): e23455.
32.	Sacco KA, Abraham RS. Consequences of B-cell-depleting therapy: hypogammaglobulinemia and impaired B-cell reconstitution. Immunotherapy, 2018, 10(8): 713-728.
33.	Ghielmini M, Rufibach K, Salles G, et al. Single agent rituximab in patients with follicular or mantle cell lymphoma: clinical and biological factors that are predictive of response and event-free survival as well as the effect of rituximab on the immune system: a study of the Swiss Group for Clinical Cancer Research (SAKK). Ann Oncol, 2005, 16(10): 1675-1682.
34.	Reynaud Q, Durieu I, Dutertre M, et al. Efficacy and safety of rituximab in auto-immune hemolytic anemia: a meta-analysis of 21 studies. Autoimmun Rev, 2015, 14(4): 304-313.
35.	诸慧, 周丰, 金剑. 56例利妥昔单抗不良反应文献分析. 中国药物警戒, 2018, 15(1): 52-56.
36.	丁坤, 范璐, 刘祥忠. 利妥昔单抗治疗致淋巴瘤患者乙型肝炎病毒再激活的机制及预防. 国际流行病学传染病学杂志, 2018, 45(4): 273-276.
37.	Dierickx D, Kentos A, Delannoy A. The role of rituximab in adults with warm antibody autoimmune hemolytic anemia. Blood, 2015, 125(21): 3223-3229.
38.	Nader K, Patel M, Ferber A. Ofatumumab in rituximab-refractory autoimmune hemolytic anemia associated with chronic lymphocytic leukemia: a case report and review of literature. Clin Lymphoma Myeloma Leuk, 2013, 13(4): 511-513.
39.	Poulet A, Jarrot PA, Mazodier K, et al. Successful treatment of systemic lupus erythematosus-related refractory autoimmune hemolytic anemia with ofatumumab. Lupus, 2019, 28(14): 1735-1736.
40.	Pejsa V, Lucijanic M, Vrkljan VA, et al. Prolonged methylprednisolone premedication prior to obinutuzumab in patients with chronic lymphocytic leukemia. Leuk Lymphoma, 2020, 61(4): 934-939.
41.	Zanella A, Barcellini W. Treatment of autoimmune hemolytic anemias. Haematologica, 2014, 99(10): 1547-1554.

1. Peñalver FJ, Alvarez-Larrán A, Díez-Martin JL, et al. Rituximab is an effective and safe therapeutic alternative in adults with refractory and severe autoimmune hemolytic anemia. Ann Hematol, 2010, 89(11): 1073-1080.
2. Barcellini W, Fattizzo B, Zaninoni A. Current and emerging treatment options for autoimmune hemolytic anemia. Expert Rev Clin Immunol, 2018, 14(10): 857-872.
3. Makis A, Kanta Z, Kalogeropoulos D, et al. Anti-CD20 treatment of autoimmune hemolytic anemia refractory to corticosteroids and azathioprine: a pediatric case report and mini review. Case Rep Hematol, 2018, 2018: 8471073.
4. Valent P, Lechner K. Diagnosis and treatment of autoimmune haemolytic anaemias in adults: a clinical review. Wien Klin Wochenschr, 2008, 120(5/6): 136-151.
5. Maung SW, Leahy M, O’Leary HM, et al. A multi-centre retrospective study of rituximab use in the treatment of relapsed or resistant warm autoimmune haemolytic anaemia. Br J Haematol, 2013, 163(1): 118-122.
6. Salles G, Barrett M, Foà R, et al. Rituximab in B-cell hematologic malignancies: a review of 20 years of clinical experience. Adv Ther, 2017, 34(10): 2232-2273.
7. Iskandar A, Hwang A, Dasanu CA. Severe warm-antibody autoimmune hemolytic anemia due to multicentric Castleman disease: responding to rituximab. J Oncol Pharm Pract, 2019, 25(8): 2016-2018.
8. Kaegi C, Wuest B, Schreiner J, et al. Systematic review of safety and efficacy of rituximab in treating immune-mediated disorders. Front Immunol, 2019, 10: 1990.
9. Pavanello F, Zucca E, Ghielmini M. Rituximab: 13 open questions after 20 years of clinical use. Cancer Treat Rev, 2017, 53: 38-46.
10. Fu R, Yan S, Wang X, et al. A monocentric retrospective study comparing pulse cyclophosphamide therapy versus low dose rituximab in the treatment of refractory autoimmune hemolytic anemia in adults. Int J Hematol, 2016, 104(4): 462-467.
11. Quinquenel A, Willekens C, Dupuis J, et al. Bendamustine and rituximab combination in the management of chronic lymphocytic leukemia-associated autoimmune hemolytic anemia: a multicentric retrospective study of the French CLL intergroup (GCFLLC/MW and GOELAMS). Am J Hematol, 2015, 90(3): 204-207.
12. Byrd JC, Murphy T, Howard RS, et al. Rituximab using a thrice weekly dosing schedule in B-cell chronic lymphocytic leukemia and small lymphocytic lymphoma demonstrates clinical activity and acceptable toxicity. J Clin Oncol, 2001, 19(8): 2153-2164.
13. Coiffier B, Haioun C, Ketterer N, et al. Rituximab (anti-CD20 monoclonal antibody) for the treatment of patients with relapsing or refractory aggressive lymphoma: a multicenter phase Ⅱ study. Blood, 1998, 92(6): 1927-1932.
14. Michel M, Terriou L, Roudot-Thoraval F, et al. A randomized and double-blind controlled trial evaluating the safety and efficacy of rituximab for warm auto-immune hemolytic anemia in adults (the RAIHA study). Am J Hematol, 2017, 92(1): 23-27.
15. Birgens H, Frederiksen H, Hasselbalch HC, et al. A phase Ⅲ randomized trial comparing glucocorticoid monotherapy versus glucocorticoid and rituximab in patients with autoimmune haemolytic anaemia. Br J Haematol, 2013, 163(3): 393-399.
16. Jaime-Pérez JC, Aguilar-Calderón P, Salazar-Cavazos L, et al. Treatment of autoimmune hemolytic anemia: real world data from a reference center in Mexico. Blood Res, 2019, 54(2): 131-136.
17. Barcellini W, Zaja F, Zaninoni A, et al. Sustained response to low-dose rituximab in idiopathic autoimmune hemolytic anemia. Eur J Haematol, 2013, 91(6): 546-551.
18. Jäger U, Barcellini W, Broome CM, et al. Diagnosis and treatment of autoimmune hemolytic anemia in adults: recommendations from the First International Consensus Meeting. Blood Rev, 2020, 41: 100648.
19. Barcellini W, Zaninoni A, Giannotta JA, et al. New insights in autoimmune hemolytic anemia: from pathogenesis to therapy stage 1. J Clin Med, 2020, 9(12): 3859.
20. Berentsen S, Randen U, Vågan AM, et al. High response rate and durable remissions following fludarabine and rituximab combination therapy for chronic cold agglutinin disease. Blood, 2010, 116(17): 3180-3184.
21. Berentsen S, Randen U, Oksman M, et al. Bendamustine plus rituximab for chronic cold agglutinin disease: results of a Nordic prospective multicenter trial. Blood, 2017, 130(4): 537-541.
22. Barcellini W, Fattizzo B, Cortelezzi A. Autoimmune hemolytic anemia, autoimmune neutropenia and aplastic anemia in the elderly. Eur J Intern Med, 2018, 58: 77-83.
23. Laribi K, Bolle D, Ghnaya H, et al. Rituximab is an effective and safe treatment of relapse in elderly patients with resistant warm AIHA. Ann Hematol, 2016, 95(5): 765-769.
24. Zecca M, Nobili B, Ramenghi U, et al. Rituximab for the treatment of refractory autoimmune hemolytic anemia in children. Blood, 2003, 101(10): 3857-3861.
25. Gupta N, Sharma S, Seth T, et al. Rituximab in steroid refractory autoimmune hemolytic anemia. Indian J Pediatr, 2012, 79(6): 803-805.
26. Teachey DT, Lambert MP. Diagnosis and management of autoimmune cytopenias in childhood. Pediatr Clin North Am, 2013, 60(6): 1489-1511.
27. Rao A, Kelly M, Musselman M, et al. Safety, efficacy, and immune reconstitution after rituximab therapy in pediatric patients with chronic or refractory hematologic autoimmune cytopenias. Pediatr Blood Cancer, 2008, 50(4): 822-825.
28. Svahn J, Fioredda F, Calvillo M, et al. Rituximab-based immunosuppression for autoimmune haemolytic anaemia in infants. Br J Haematol, 2009, 145(1): 96-100.
29. Ansari S, Tashvighi M, Darbandi B, et al. Rituximab for child with chronic relapsing autoimmune hemolytic anemia. Pediatr Hematol Oncol, 2011, 28(2): 164-166.
30. Ducassou S, Leverger G, Fernandes H, et al. Benefits of rituximab as a second-line treatment for autoimmune haemolytic anaemia in children: a prospective French cohort study. Br J Haematol, 2017, 177(5): 751-758.
31. Wang H, Yan S, Liu H, et al. Infection risk in autoimmune hematological disorders with low-dose rituximab treatment. J Clin Lab Anal, 2020, 34(10): e23455.
32. Sacco KA, Abraham RS. Consequences of B-cell-depleting therapy: hypogammaglobulinemia and impaired B-cell reconstitution. Immunotherapy, 2018, 10(8): 713-728.
33. Ghielmini M, Rufibach K, Salles G, et al. Single agent rituximab in patients with follicular or mantle cell lymphoma: clinical and biological factors that are predictive of response and event-free survival as well as the effect of rituximab on the immune system: a study of the Swiss Group for Clinical Cancer Research (SAKK). Ann Oncol, 2005, 16(10): 1675-1682.
34. Reynaud Q, Durieu I, Dutertre M, et al. Efficacy and safety of rituximab in auto-immune hemolytic anemia: a meta-analysis of 21 studies. Autoimmun Rev, 2015, 14(4): 304-313.
35. 诸慧, 周丰, 金剑. 56例利妥昔单抗不良反应文献分析. 中国药物警戒, 2018, 15(1): 52-56.
36. 丁坤, 范璐, 刘祥忠. 利妥昔单抗治疗致淋巴瘤患者乙型肝炎病毒再激活的机制及预防. 国际流行病学传染病学杂志, 2018, 45(4): 273-276.
37. Dierickx D, Kentos A, Delannoy A. The role of rituximab in adults with warm antibody autoimmune hemolytic anemia. Blood, 2015, 125(21): 3223-3229.
38. Nader K, Patel M, Ferber A. Ofatumumab in rituximab-refractory autoimmune hemolytic anemia associated with chronic lymphocytic leukemia: a case report and review of literature. Clin Lymphoma Myeloma Leuk, 2013, 13(4): 511-513.
39. Poulet A, Jarrot PA, Mazodier K, et al. Successful treatment of systemic lupus erythematosus-related refractory autoimmune hemolytic anemia with ofatumumab. Lupus, 2019, 28(14): 1735-1736.
40. Pejsa V, Lucijanic M, Vrkljan VA, et al. Prolonged methylprednisolone premedication prior to obinutuzumab in patients with chronic lymphocytic leukemia. Leuk Lymphoma, 2020, 61(4): 934-939.
41. Zanella A, Barcellini W. Treatment of autoimmune hemolytic anemias. Haematologica, 2014, 99(10): 1547-1554.

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