Ibrutinib treatment for 2 cases of relapsed/refractory autoimmune hemolytic anemia: a pilot study
10.3760/cma.j.issn.0253-2727.2020.05.009
- VernacularTitle:伊布替尼治疗复发/难治原发性自身免疫性溶血性贫血二例——探索性研究
- Author:
Liwei FANG
1
;
Hong PAN
;
Jun SHI
Author Information
1. 中国医学科学院、北京协和医学院血液病医院（中国医学科学院血液学研究所），实验血液学国家重点实验室，国家血液系统疾病临床医学研究中心，天津 300020
- Keywords:
Autoimmune hemolytic anemia;
Relapsed/refractory;
Ibrutinib
- From:
Chinese Journal of Hematology
2020;41(5):412-416
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of ibrutinib treatment for relapsed/refractory (R/R) primary autoimmune hemolytic anemia (AIHA) .Methods:Two cases of primary AIHA with relapse events were refractory to glucocorticoid, anti-CD20 monoclonal antibody, immunosuppressive drugs, and splenectomy (case 1 only) . Ibrutinib treatment was administered at an initial dose of 280 mg/d (420 mg/d for case 1 from the 3rd to 8th week) .Results:Both patients achieved transfusion independence and HGB>20 g/L above baseline after 2 weeks (partial response) . For case 1, HGB concentration restored to 113 g/L but with incomplete hemolysis recovery after 10 weeks; HGB reached the level of 118 g/L, also with incomplete hemolysis recovery, after 6 weeks in case 2. They all acquired complete response with incomplete hemolysis recovery (CRi) . The responses sustained 14 weeks and 10 weeks after follow-up at 16 weeks and 12 weeks, respectively. During the treatment, hematologic and nonhematologic toxicity is mild and acceptable.Conclusion:Ibrutinib alone is effective for the 2 R/R primary AIHA cases. We need further clinical trial to identify its efficacy and safety.
