Tags

Type your tag names separated by a space and hit enter

Management of refractory autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation: current perspectives.
J Blood Med 2019; 10:265-278JB

Abstract

Autoimmune hemolytic anemia (AIHA) is increasingly observed after allogeneic hematopoietic stem cell transplantation (allo-HSCT), with a reported incidence between 4% and 6%. The disease is generally severe and refractory to standard therapy, with high mortality, and there are neither defined therapies, nor prospective clinical trials addressing the best treatment. Most of the knowledge on the therapy of AIHAs derives from primary forms, which are highly heterogeneous as well, further complicating the management of post-allo-HSCT forms. The review addresses the risk factors associated with post-allo-AIHA, including unrelated donor, the development of chronic extensive graft-versus-host disease, CMV reactivation, nonmalignant diagnosis pre-HSCT, and alemtuzumab use in conditioning regimens. Regarding therapy, we describe standard treatments, such as corticosteroids, intravenous immunoglobulin, splenectomy, rituximab, cyclophosphamide, and plasma exchange, which have lower response rates than those reported in primary forms. New therapeutic options, including sirolimus, bortezomib, abatacept, daratumumab and complement inhibitors, are promising tools for this detrimental complication occurring after allo-HSCT.

Authors+Show Affiliations

UOC Ematologia, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Milano, Italy.UOC Ematologia, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Milano, Italy.UOC Ematologia, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Milano, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31496855

Citation

Barcellini, Wilma, et al. "Management of Refractory Autoimmune Hemolytic Anemia After Allogeneic Hematopoietic Stem Cell Transplantation: Current Perspectives." Journal of Blood Medicine, vol. 10, 2019, pp. 265-278.
Barcellini W, Fattizzo B, Zaninoni A. Management of refractory autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation: current perspectives. J Blood Med. 2019;10:265-278.
Barcellini, W., Fattizzo, B., & Zaninoni, A. (2019). Management of refractory autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation: current perspectives. Journal of Blood Medicine, 10, pp. 265-278. doi:10.2147/JBM.S190327.
Barcellini W, Fattizzo B, Zaninoni A. Management of Refractory Autoimmune Hemolytic Anemia After Allogeneic Hematopoietic Stem Cell Transplantation: Current Perspectives. J Blood Med. 2019;10:265-278. PubMed PMID: 31496855.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of refractory autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation: current perspectives. AU - Barcellini,Wilma, AU - Fattizzo,Bruno, AU - Zaninoni,Anna, Y1 - 2019/08/08/ PY - 2019/05/10/received PY - 2019/07/10/accepted PY - 2019/9/10/entrez PY - 2019/9/10/pubmed PY - 2019/9/10/medline KW - allogeneic hematopoietic stem cell transplantation KW - autoimmune hemolytic anemia KW - bortezomib and daratumumab KW - rituximab KW - sirolimus and abatacept SP - 265 EP - 278 JF - Journal of blood medicine JO - J Blood Med VL - 10 N2 - Autoimmune hemolytic anemia (AIHA) is increasingly observed after allogeneic hematopoietic stem cell transplantation (allo-HSCT), with a reported incidence between 4% and 6%. The disease is generally severe and refractory to standard therapy, with high mortality, and there are neither defined therapies, nor prospective clinical trials addressing the best treatment. Most of the knowledge on the therapy of AIHAs derives from primary forms, which are highly heterogeneous as well, further complicating the management of post-allo-HSCT forms. The review addresses the risk factors associated with post-allo-AIHA, including unrelated donor, the development of chronic extensive graft-versus-host disease, CMV reactivation, nonmalignant diagnosis pre-HSCT, and alemtuzumab use in conditioning regimens. Regarding therapy, we describe standard treatments, such as corticosteroids, intravenous immunoglobulin, splenectomy, rituximab, cyclophosphamide, and plasma exchange, which have lower response rates than those reported in primary forms. New therapeutic options, including sirolimus, bortezomib, abatacept, daratumumab and complement inhibitors, are promising tools for this detrimental complication occurring after allo-HSCT. SN - 1179-2736 UR - https://www.unboundmedicine.com/medline/citation/31496855/Management_of_refractory_autoimmune_hemolytic_anemia_after_allogeneic_hematopoietic_stem_cell_transplantation:_current_perspectives L2 - https://dx.doi.org/10.2147/JBM.S190327 DB - PRIME DP - Unbound Medicine ER -