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Rituximab and alemtuzumab produced 100% response rate in autoimmune cytopenias
Gómez-Almaguer D. Blood. 2010;DOI:10.1182/blood-2010-06-291831.
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Patients with steroid-refractory autoimmune cytopenias had an overall response rate of 100% and a complete response rate of 58% when assigned to the combination of rituximab and alemtuzumab.
Eleven patients with immune thrombocytopenic purpura and eight with steroid-refractory autoimmune hemolytic anemia were included in the study. Two others were not assessable for response. Eligible patients had previously received treatment with at least one line of therapy or followed a chronic relapsing course.
Patients were assigned to 10 mg alemtuzumab (Campath, Ilex) on days 1 through 3, plus four weekly doses of 100 mg IV rituximab (Rituxan, Genentech).
Complete response for patients with refractory autoimmune hemolytic anemia was defined as normalization of hemoglobin and resolution of hemolysis. Partial response was defined as a stable increase in hemoglobin concentration of at least 2.0 g/dL, resolution of hemolysis and transfusion independence.
Patients with ITP were deemed to have complete response if they had a platelet count of >150 x 109/L or partial response if they had a platelet count of >50 x 109/L on two consecutive occasions.
Five patients with ITP had complete response and six had partial response. Median duration of complete response was 46 weeks, and all patients had a response at 1 week.
Six patients with autoimmune hemolytic anemia and two others had partial response. Both of the partial responders and three of the complete responders relapsed. Median duration of complete response was 46 weeks.
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