Efficacy and safety of splenectomy in adult autoimmune hemolytic anemia

Autoimmune hemolytic anemia (AIHA) is a rare hematologic disease, primarily affecting adults or children with immunodeficiency disease. First-line therapy consists of long course of steroids administration, with an early complete response rate (CRr) of 75-80%, but up to 20-30% of patients requires a...

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Published inOpen medicine (Warsaw, Poland) Vol. 11; no. 1; pp. 374 - 380
Main Authors Giudice, Valentina, Rosamilio, Rosa, Ferrara, Idalucia, Seneca, Elisa, Serio, Bianca, Selleri, Carmine
Format Journal Article
LanguageEnglish
Published Poland De Gruyter Open 01.01.2016
De Gruyter
Subjects
Autoimmune hemolytic anemia
Elderly
Review
Splenectomy
Splenectomy
Autoimmune hemolytic anemia
Elderly
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ISSN2391-5463
2391-5463
DOI10.1515/med-2016-0068

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Summary:Autoimmune hemolytic anemia (AIHA) is a rare hematologic disease, primarily affecting adults or children with immunodeficiency disease. First-line therapy consists of long course of steroids administration, with an early complete response rate (CRr) of 75-80%, but up to 20-30% of patients requires a second-line therapy. Rituximab is the first choice in refractory old AIHA patients, because of its safety and efficacy (early CRr at 80-90% and at 68% at 2-3 years). For this reason, splenectomy is even less chosen as second-line therapy in elderly, even though laparoscopic technique decreased complication and mortality rates. However, splenectomy can be still considered a good therapeutic option with a CRr of 81% at 35.6 months in patients older than 60 year-old, when rituximab administration cannot be performed.
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ISSN:2391-5463
2391-5463
DOI:10.1515/med-2016-0068