Autoimmune cytopenia

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Ronak H. Mistry, DO
Vanderbilt University
Nashville, TN

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Benjamin Tillman, MD
Vanderbilt University
Nashville, TN
2 regimens on this page
2 variants on this page


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.

Relapsed or refractory

Alemtuzumab monotherapy

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Regimen

Study Evidence Efficacy
Willis et al. 2001 Phase II 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

  1. 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 II Durable CR observed in patients with ALPS

Immunosuppressive therapy

6-month course, extended for those with a favorable response

References

  1. 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