Rituximab-induced acute liver failure after an allogeneic transplantation for chronic myeloid leukemia

Am J Hematol. 2005 Sep;80(1):43-5. doi: 10.1002/ajh.20413.

Abstract

Autoimmune hemolytic anemia (AIHA) is a well-recognized complication of allogeneic bone marrow transplantation (BMT) and can affect up to 5% patients. Several recent case reports suggested the efficacy of anti-CD20 monoclonal antibody, rituximab, in treating this condition. We report our experience with a 21-year-old female with accelerated-phase chronic myeloid leukemia who underwent allogeneic hematopoietic stem cell transplantation from a matched, unrelated donor. The patient developed autoimmune hemolytic anemia that failed to respond to steroids, intravenous immunoglobulins, and plasma exchange. She was then treated with rituximab that resulted in fatal acute liver toxicity.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents / adverse effects*
  • Fatal Outcome
  • Female
  • Histocompatibility Testing
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy*
  • Liver / pathology
  • Liver Failure, Acute / chemically induced*
  • Liver Failure, Acute / pathology
  • Necrosis
  • Rituximab
  • Transplantation, Homologous

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents
  • Rituximab