Anti‐CD20 monoclonal antibody (Rituximab) for life‐threatening autoimmune haemolytic anaemia in a patient with systemic lupus erythematosus

Perrotta, Silverio; Locatelli, Franco; Manna, Angela La; Cennamo, Lucia; Stefano, Piero De; Nobili, Brúno

doi:10.1046/j.1365-2141.2002.03278.x

Cited by 119 publications

(51 citation statements)

References 11 publications

(15 reference statements)

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“…In the last decade, Rituximab has been given to many B cell lymphoma patients [86]. Rituximab has also been explored for treating autoimmune diseases, such as rheumatoid arthritis, SLE, autoimmune hemolytic anemia and immune thrombocytopenic purpura, and showed clear efficacy [87][88][89][90][91][92]. Unlike T1DM, all these autoimmune disorders are primarily B cell-mediated diseases, although T cells also play an important role in the pathogenesis.…”

Section: B Cells As a Possible Therapeutic Target?mentioning

confidence: 99%

B Cells in Autoimmune Diabetes

Wong

Liu²

2005

Rev Diab Stud

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■ AbstractAutoantibodies have been used as good markers for the prediction of future development of type 1 diabetes mellitus (T1DM), but are not thought to be pathogenic in this disease. The role of B cells that produce autoantibodies in the pathogenesis of human T1DM is largely unknown. In the non-obese diabetic (NOD) mouse model of autoimmune diabetes, it has been shown that B cells may contribute multifariously to the pathogenesis of the disease. Some aspects of deficiencies of B cell tolerance may lead to the circulation of autoreactive B cells. In addition, the antigenpresenting function of autoantigen specific B cells is likely to be particularly important, and autoantibodies are also considered to play a critical role. This review discusses the possible aspects of B cells involved in the development of autoimmune diabetes.

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Section: B Cells As a Possible Therapeutic Target?mentioning

confidence: 99%

B Cells in Autoimmune Diabetes

Wong

Liu²

2005

Rev Diab Stud

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“…Reports of the beneficial effects of rituximab in patients with proliferative lupus nephritis have also been published during the last few years (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24).…”

mentioning

confidence: 99%

Histopathologic and clinical outcome of rituximab treatment in patients with cyclophosphamide‐resistant proliferative lupus nephritis

Gunnarsson¹,

Sundelin²,

Jónsdóttir³

et al. 2007

Arthritis & Rheumatism

221

149

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Objective. Rituximab is a monoclonal antibody directed against the CD20 marker of B cells. Because of its ability to deplete B lymphocytes, it has been suggested that the drug could be of benefit in B celldependent diseases, including systemic lupus erythematosus (SLE). The purpose of this study was to investigate the histopathologic and clinical effects of combination treatment with rituximab and cyclophosphamide (CYC) in patients with CYC-resistant proliferative lupus nephritis.Methods. Seven female patients with proliferative lupus nephritis were treated with rituximab in combination with CYC. Renal biopsies were performed before treatment and during followup. SLE activity was evaluated by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and the British Isles Lupus Assessment Group index. In 6 of the 7 patients, immunostaining of lymphocyte subpopulations in the renal tissue was performed before treatment and during followup.Results. At 6 months of followup, significant clinical improvement was noted, with a reduction in SLEDAI scores (from a mean of 15 to 3), anti-doublestranded DNA antibody levels (from a mean of 174 IU/ml to 56 IU/ml), and anti-C1q antibody levels (from a mean of 35 units/ml to 22 units/ml). On repeat renal biopsy, improvement in the histopathologic class of nephritis occurred in a majority of patients, and a decrease in the renal activity index was noted (from 6 to 3). A reduction in the number of CD3, CD4, and CD20 cells in the renal interstitium was noted in 50% of the patients on repeat biopsy. Conclusion. At 6 months of followup, all patients had responded both clinically and histopathologically to combination therapy. For patients with proliferative lupus nephritis who fail to respond to conventional immunosuppressive therapy including CYC, combined treatment with rituximab and CYC may constitute a new treatment option.

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“…Nineteen months following a second 4-week course of rituximab, given 3 weeks after the first unsuccessful one, the adolescent remained transfusion independent, although it took more than 6 weeks after the second course of the antibody for the hemolysis to decrease [12]. Finally, three more case reports of successful treatment of one child with AIHA, another with Wiskott-Aldrich syndrome complicated by AIHA following a T-cell-depleted haploidentical stem cell transplantation, and an 18-year-old girl with SLE and lifethreatening AIHA unresponsive to corticosteroids, intravenous gammaglobulin, and cyclosporin have been published [13][14][15].…”

Section: Autoimmune Hemolytic Anemia (Aiha)mentioning

confidence: 99%

Rituximab for refractory Evans syndrome and other immune‐mediated hematologic diseases

et al. 2004

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The authors describe a 21-year-old man with long-lasting Evans syndrome refractory to corticosteroids and immunosuppressive agents; the patient responded to four weekly infusions of rituximab. The patient relapsed with thrombocytopenia 7 months post-therapy and was successfully re-treated with two weekly doses of the same monoclonal antibody. He remains in remission for 7-plus months after the second treatment. Therapy was well tolerated, and no infectious complications occurred, despite avoiding administration of prophylactic gammaglobulin. Rituximab appears safe and modestly effective in a variety of immune-mediated hematologic diseases, including autoimmune hemolytic anemia, chronic immune thrombocytopenia, Evans syndrome, pure red cell aplasia, mixed type II cryoglobulinemia, cold agglutinin disease, and Waldenströ m's macroglobulinemia. However, as most of the published literature consists of case reports and small case series, international collaboration is essential in order to better define the efficacy and safety of this agent in children and adults with hematologic diseases. Am.

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Anti‐CD20 monoclonal antibody (Rituximab) for life‐threatening autoimmune haemolytic anaemia in a patient with systemic lupus erythematosus

Cited by 119 publications

References 11 publications

B Cells in Autoimmune Diabetes

B Cells in Autoimmune Diabetes

Histopathologic and clinical outcome of rituximab treatment in patients with cyclophosphamide‐resistant proliferative lupus nephritis

Rituximab for refractory Evans syndrome and other immune‐mediated hematologic diseases

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