Abstract
A 58-year-old man with warm-antibody-mediated autoimmune hemolytic anemia (AIHA) refractory to prednisolone, azathioprine, splenectomy, rituximab and combination chemotherapy, and with unacceptably high transfusion requirement, was treated with alemtuzumab. After a cumulative dose of 883 mg of alemtuzumab, the AIHA remitted completely, with normalization of hemoglobin and transfusion-independence. The major side effect was reactivation of cytomegalovirus, which was controlled with intravenous and oral ganciclovir. This case showed that alemtuzumab might be of use in therapy-refractory AIHA.
MeSH terms
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Alemtuzumab
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Anemia, Hemolytic, Autoimmune / complications
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Anemia, Hemolytic, Autoimmune / drug therapy*
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Anemia, Hemolytic, Autoimmune / surgery
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Anemia, Hemolytic, Autoimmune / therapy
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Antibodies, Monoclonal / adverse effects
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Antibodies, Monoclonal / therapeutic use*
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Antibodies, Monoclonal, Humanized
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Antibodies, Monoclonal, Murine-Derived
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Antibodies, Neoplasm / adverse effects
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Antibodies, Neoplasm / therapeutic use*
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Antigens, CD / immunology
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Antigens, Neoplasm / immunology
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Antiviral Agents / therapeutic use
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Azathioprine / therapeutic use
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Blood Transfusion
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CD52 Antigen
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Cytomegalovirus / drug effects
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Cytomegalovirus / physiology
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Cytomegalovirus Infections / complications
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Cytomegalovirus Infections / drug therapy
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Drug Resistance
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Ganciclovir / analogs & derivatives
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Ganciclovir / therapeutic use
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Glycoproteins / immunology
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Humans
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Immunosuppressive Agents / adverse effects
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Immunosuppressive Agents / therapeutic use*
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Male
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Middle Aged
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Prednisolone / therapeutic use
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Remission Induction
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Rituximab
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Splenectomy
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Valganciclovir
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Viremia / complications
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Viremia / drug therapy
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Virus Activation / drug effects
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Humanized
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Antibodies, Monoclonal, Murine-Derived
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Antibodies, Neoplasm
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Antigens, CD
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Antigens, Neoplasm
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Antiviral Agents
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CD52 Antigen
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CD52 protein, human
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Glycoproteins
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Immunosuppressive Agents
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Alemtuzumab
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Rituximab
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Prednisolone
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Valganciclovir
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Azathioprine
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Ganciclovir