TREATMENT OF COLD AGGLUTININ DISEASE WITH RITUXIMAB

BACKGROUND Cold agglutinin disease is an uncommon hemolytic anemia associated sometimes withlow-grade B-cell lymphoproliferative disorders. The disease results from increased production of anti erythrocyte antibodies. Standard treatment is mostly unsuccesful.Patient and A 76-years-old patient is presented who was diagnosed with hemolytic anemia caused bymethods cold agglutinins. Later a bone marrow located B cell CD 20 non Hodgkin lymphoma wasdiagnosed. Standard treatment was unsuccesful, so she received rituximab. After 3 cyclesthe signs of hemolysis disappeared and the hemoglobin level normalized. The patient istreated every 3 months with rituximab and is in complete remission. CONCLUSIONS Treatment with rituximab is used also for treating immune cytopenias. There are somereports of treating cold agglutinin anemia, where standard treatment is mostly withoutsuccess. As this is a rare disease only some small studies and case reports have demonstrated the beneficial effect of rituximab on this type of anemia. Despite its high price,rituximab has numerous advantages: immediate and long lasting effect and relatively fewside effects