Difference between revisions of "Autoimmune cytopenia"
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''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.'' | ''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.'' | ||
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| + | =Guidelines= | ||
| + | =="How I Treat"== | ||
| + | *'''2022:''' Porpaczy & Jäger [https://doi.org/10.1182/blood.2019003686 How I manage autoimmune cytopenias in patients with lymphoid cancer] | ||
=Relapsed or refractory= | =Relapsed or refractory= | ||
Revision as of 13:45, 8 May 2022
| Page editor | Section editor | ||
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Ronak H. Mistry, DO Vanderbilt University Nashville, TN  @rmistry91
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Benjamin Tillman, MD Vanderbilt University Nashville, TN |
2 regimens on this page
2 variants on this page
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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.
Guidelines
"How I Treat"
- 2022: Porpaczy & Jäger How I manage autoimmune cytopenias in patients with lymphoid cancer
Relapsed or refractory
Alemtuzumab monotherapy
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Regimen
| Study | Evidence | Efficacy |
|---|---|---|
| Willis et al. 2001 | 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 verified protocol PubMed
Sirolimus monotherapy
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Regimen
| Study | Evidence | Efficacy |
|---|---|---|
| Bride et al. 2015 | Phase 2 | Durable CR observed in patients with ALPS |
Immunosuppressive therapy
- Sirolimus (Rapamune) 2 to 2.5 mg/m2/day PO
- See manuscript for recommended dose adjustments
6-month course, extended for those with a favorable response
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 protocol PubMed