What is the role of rituximab in the treatment of cold agglutinin disease?

Updated: Aug 28, 2018
  • Author: Salman Abdullah Aljubran, MD; Chief Editor: Michael A Kaliner, MD  more...
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Answer

The anti-CD20 monoclonal antibody rituximab depletes B-lymphocytes, thereby interfering with the production of cold agglutinin. [51] In case studies, patients with cold agglutinin disease have responded to treatment with rituximab. One case series suggests higher response rates than were previously achieved with alkylators, glucocorticoids, or purine nucleoside analogues. [1, 52]

Studies demonstrate a response rate of 54% with a median response duration of 11 months when rituximab is used as a single agent. Purine analogs, such as fludarabine, in combination with rituximab, induced a 76% response rate in an uncontrolled small prospective trial of 29 subjects. [23, 53, 54]


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