What are precautions for the use of medications 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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The reader is advised to read the package insert approved by the US Food and Drug Administration (FDA) before using any of the agents listed.

In general, the use of chemotherapeutic agents—which have long-term consequences for the patient and are associated with secondary malignancies, such as leukemias, that are hard to treat—requires very careful decision making in collaboration with a well-informed patient. These agents should be used only for life-threatening, severely symptomatic disease. Therapy also may need to be administered intermittently or infrequently, as the case demands. Tailor therapy to individual needs.

Although alkylating agents have been used in the past and references to these treatments are part of standard texts, the authors suggest that these drugs not be used in patients with cold agglutinin disease, because of the potential for long-term adverse effects from such therapy.

Identifying the proper drug for use in a patient depends on patient characteristics and patient participation in the decision-making process. No guarantees of success can be given with any therapy in cold agglutinin disease.

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