Autoimmune haemolytic anaemias: A retrospective study of 93 patients
| Autor: | Grupo Español de Eritropatología, Silvia de la Iglesia, David Beneitez, Marta Morado Arias, Aurea Cervera, Beatriz Arrizabalaga, Ana Villegas, Isabel Gutiérrez Jomarrón, Montserrat López Rubio, Ascensión Herrera, María Isabel Sáez, Valle Recasens |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
biology business.industry medicine.medical_treatment Splenectomy Retrospective cohort study Disease Pathophysiology Serology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine biology.protein Observational study Rituximab 030212 general & internal medicine Antibody business medicine.drug |
| Zdroj: | Medicina Clínica (English Edition). 154:331-337 |
| ISSN: | 2387-0206 |
| Popis: | Introduction Autoimmune haemolytic anaemia (AIHA) is an infrequent and heterogeneous disease in its pathophysiology and clinical behaviour, therefore it is generally managed empirically. Patients and methods We conducted an observational, retrospective and multicentre study of 93 patients diagnosed with AHAI in 9 Spanish hospitals between 1987 and 2017, with a median follow-up of 28 months. Results Median age of 67 years; 85% AHAI for hot antibodies and 64% primary AHAI. The lowest haemoglobin values at diagnosis related to patients under 45 years of age and serological type IgG+C. Of the patients, 92% received first line treatment, 54% second line, and 27% third line. The warm AHAI were treated in first line with steroids, with overall responses of 83% and complete of 58%. Rituximab in monotherapy or in association with steroids was administered to 34 patients with overall responses close to 100% (complete responses 40–60%), relegating splenectomy to the third line. The immunosuppressive treatment was administered in patients with autoimmune diseases or in corticoid-dependent patients. Discussion We found high rates of response to steroids, with very prolonged treatments that cause side effects and corticoid dependence in a third of patients. The combination of steroids with rituximab in the first line, could be indicated in patients with low levels of haemoglobin and serological type IgG+C. The high relapse rates make necessary the development of randomised studies with new drugs or the combination with existing ones, which allow longer response times and with fewer side effects. |
| Databáze: | OpenAIRE |
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