Difference between revisions of "Autoimmune cytopenia"
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− | </span> | + | {{#lst:Editorial board transclusions|heme}} |
− | + | ''This is an umbrella category that includes Felty's syndrome (autoimmune neutropenia), [[#Autoimmune_thrombocytopenic_purpura_(ITP)|autoimmune thrombocytopenia (ITP)]], [[autoimmune hemolytic anemia (AIHA)]], and Evan's syndrome (AIHA & ITP). Please see the respective page(s) for disease-specific therapies. This page includes regimens that were used more broadly.'' | |
− | + | *''We have moved [[How I Treat]] articles to a dedicated page.'' | |
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− | |<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] | + | |<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} [[Tutorial#Regimens|regimens]] on this page</b></font></div> |
− | <div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] | + | <div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div> |
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=Relapsed or refractory= | =Relapsed or refractory= | ||
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==Alemtuzumab monotherapy {{#subobject:34416b|Regimen=1}}== | ==Alemtuzumab monotherapy {{#subobject:34416b|Regimen=1}}== | ||
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===Regimen {{#subobject:#30ab57|Variant=1}}=== | ===Regimen {{#subobject:#30ab57|Variant=1}}=== | ||
− | {| class="wikitable" style="width: | + | {| class="wikitable sortable" style="width: 80%; text-align:center;" |
− | !Study | + | !style="width: 25%"|Study |
− | ![[Levels_of_Evidence#Evidence|Evidence]] | + | !style="width: 25%"|Dates of enrollment |
− | ![[Levels_of_Evidence#Efficacy|Efficacy]] | + | !style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]] |
+ | !style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]] | ||
|- | |- | ||
− | |[ | + | |[https://doi.org/10.1046/j.1365-2141.2001.03039.x Willis et al. 2001] |
− | |style="background-color:#91cf61"|Phase | + | |1995-11 to 2000-08 |
+ | |style="background-color:#91cf61"|Phase 2 | ||
|style="background-color:#b5b5b5"|ORR: 71% | |style="background-color:#b5b5b5"|ORR: 71% | ||
|- | |- | ||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Immunosuppressive therapy==== | ====Immunosuppressive therapy==== | ||
*[[Alemtuzumab (Campath)]] as follows: | *[[Alemtuzumab (Campath)]] as follows: | ||
**Test dose: 1 mg IV over 60 minutes once | **Test dose: 1 mg IV over 60 minutes once | ||
**Days 1 to 10: 10 mg IV over 4 hours once per day | **Days 1 to 10: 10 mg IV over 4 hours once per day | ||
− | |||
'''10-day course''' | '''10-day course''' | ||
− | + | </div></div> | |
===References=== | ===References=== | ||
− | # Willis F, Marsh JC, Bevan DH, Killick SB, Lucas G, Griffiths R, Ouwehand W, Hale G, Waldmann H, Gordon-Smith EC. The effect of treatment with Campath-1H in patients with autoimmune cytopenias. Br J Haematol. 2001 Sep;114(4):891-8. [ | + | # Willis F, Marsh JC, Bevan DH, Killick SB, Lucas G, Griffiths R, Ouwehand W, Hale G, Waldmann H, Gordon-Smith EC. The effect of treatment with Campath-1H in patients with autoimmune cytopenias. Br J Haematol. 2001 Sep;114(4):891-8. [https://doi.org/10.1046/j.1365-2141.2001.03039.x link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/11564082/ PubMed] |
==Sirolimus monotherapy {{#subobject:35516b|Regimen=1}}== | ==Sirolimus monotherapy {{#subobject:35516b|Regimen=1}}== | ||
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===Regimen {{#subobject:#41ab57|Variant=1}}=== | ===Regimen {{#subobject:#41ab57|Variant=1}}=== | ||
− | {| class="wikitable" style="width: | + | {| class="wikitable sortable" style="width: 80%; text-align:center;" |
− | !Study | + | !style="width: 25%"|Study |
− | ![[Levels_of_Evidence#Evidence|Evidence]] | + | !style="width: 25%"|Dates of enrollment |
+ | !style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]] | ||
|- | |- | ||
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4705607/ Bride et al. 2015] | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4705607/ Bride et al. 2015] | ||
− | |style="background-color:#91cf61"|Phase | + | |Not reported |
+ | |style="background-color:#91cf61"|Phase 2 | ||
+ | | style="background-color:#91cf60" |Durable CR observed in patients with ALPS | ||
|- | |- | ||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Immunosuppressive therapy==== | ====Immunosuppressive therapy==== | ||
− | *[[Sirolimus (Rapamune)]] 2 | + | *[[Sirolimus (Rapamune)]] 2 to 2.5 mg/m<sup>2</sup>/day PO |
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'''6-month course, extended for those with a favorable response''' | '''6-month course, extended for those with a favorable response''' | ||
− | + | </div> | |
+ | <div class="toccolours" style="background-color:#fff2ae"> | ||
+ | ====Dose and schedule modifications==== | ||
+ | *See manuscript for recommended dose adjustments | ||
+ | </div></div> | ||
===References=== | ===References=== | ||
− | # Bride KL, Vincent T, Smith-Whitley K, Lambert MP, Bleesing JJ, Seif AE, Manno CS, Casper J, Grupp SA, Teachey DT. Sirolimus is effective in relapsed/refractory autoimmune cytopenias: results of a prospective multi-institutional trial. Blood. 2016 Jan 7;127(1):17-28. Epub 2015 Oct 26. [ | + | # Bride KL, Vincent T, Smith-Whitley K, Lambert MP, Bleesing JJ, Seif AE, Manno CS, Casper J, Grupp SA, Teachey DT. Sirolimus is effective in relapsed/refractory autoimmune cytopenias: results of a prospective multi-institutional trial. Blood. 2016 Jan 7;127(1):17-28. Epub 2015 Oct 26. [https://doi.org/10.1182/blood-2015-07-657981 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4705607/ link to PMC article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/26504182/ PubMed] [https://clinicaltrials.gov/study/NCT00392951 NCT00392951] |
− | + | [[Category:Autoimmune cytopenia regimens]] | |
− | [[Category:Autoimmune | ||
[[Category:Disease-specific pages]] | [[Category:Disease-specific pages]] | ||
[[Category:Autoimmune hematologic conditions]] | [[Category:Autoimmune hematologic conditions]] | ||
− | [[Category:Hemolytic | + | [[Category:Hemolytic process]] |
[[Category:Cytopenias]] | [[Category:Cytopenias]] |
Latest revision as of 11:07, 6 July 2024
Section editor | |
---|---|
Benjamin Tillman, MD Vanderbilt University Nashville, TN, USA |
This is an umbrella category that includes Felty's syndrome (autoimmune neutropenia), autoimmune thrombocytopenia (ITP), autoimmune hemolytic anemia (AIHA), and Evan's syndrome (AIHA & ITP). Please see the respective page(s) for disease-specific therapies. This page includes regimens that were used more broadly.
- We have moved How I Treat articles to a dedicated page.
2 regimens on this page
2 variants on this page
|
Relapsed or refractory
Alemtuzumab monotherapy
Regimen
Study | Dates of enrollment | Evidence | Efficacy |
---|---|---|---|
Willis et al. 2001 | 1995-11 to 2000-08 | Phase 2 | ORR: 71% |
Immunosuppressive therapy
- Alemtuzumab (Campath) as follows:
- Test dose: 1 mg IV over 60 minutes once
- Days 1 to 10: 10 mg IV over 4 hours once per day
10-day course
References
- Willis F, Marsh JC, Bevan DH, Killick SB, Lucas G, Griffiths R, Ouwehand W, Hale G, Waldmann H, Gordon-Smith EC. The effect of treatment with Campath-1H in patients with autoimmune cytopenias. Br J Haematol. 2001 Sep;114(4):891-8. link to original article contains dosing details in manuscript PubMed
Sirolimus monotherapy
Regimen
Study | Dates of enrollment | Evidence | Efficacy |
---|---|---|---|
Bride et al. 2015 | Not reported | Phase 2 | Durable CR observed in patients with ALPS |
Immunosuppressive therapy
- Sirolimus (Rapamune) 2 to 2.5 mg/m2/day PO
6-month course, extended for those with a favorable response
Dose and schedule modifications
- See manuscript for recommended dose adjustments
References
- Bride KL, Vincent T, Smith-Whitley K, Lambert MP, Bleesing JJ, Seif AE, Manno CS, Casper J, Grupp SA, Teachey DT. Sirolimus is effective in relapsed/refractory autoimmune cytopenias: results of a prospective multi-institutional trial. Blood. 2016 Jan 7;127(1):17-28. Epub 2015 Oct 26. link to original article link to PMC article contains dosing details in abstract PubMed NCT00392951