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= | =Guidelines= | ||
=="How I Treat"== | =="How I Treat"== | ||
*'''2022:''' Porpaczy & Jäger [https://doi.org/10.1182/blood.2019003686 How I manage autoimmune cytopenias in patients with lymphoid cancer] | *'''2022:''' Porpaczy & Jäger [https://doi.org/10.1182/blood.2019003686 How I manage autoimmune cytopenias in patients with lymphoid cancer] | ||
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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}}=== | ||
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====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 | ||
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'''10-day course''' | '''10-day course''' | ||
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===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. [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] | # 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] | ||
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==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}}=== | ||
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====Immunosuppressive therapy==== | ====Immunosuppressive therapy==== | ||
*[[Sirolimus (Rapamune)]] 2 to 2.5 mg/m<sup>2</sup>/day PO | *[[Sirolimus (Rapamune)]] 2 to 2.5 mg/m<sup>2</sup>/day PO | ||
**See manuscript for recommended dose adjustments | **See manuscript for recommended dose adjustments | ||
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'''6-month course, extended for those with a favorable response''' | '''6-month course, extended for those with a favorable response''' | ||
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===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. [http://www.bloodjournal.org/content/127/1/17.long 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] | # 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. [http://www.bloodjournal.org/content/127/1/17.long 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] | ||
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[[Category:Autoimmune cytopenia regimens]] | [[Category:Autoimmune cytopenia regimens]] | ||
[[Category:Disease-specific pages]] | [[Category:Disease-specific pages]] | ||
Revision as of 00:19, 1 March 2023
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
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 dosing details in manuscript PubMed
Sirolimus monotherapy
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 dosing details in abstract PubMed