Part 1: Autoimmune Hemolytic Anemia

Thomas G. DeLoughery, MD

Professor of Medicine, Pathology, and Pediatrics, Division of Hematology/Medical Oncology,
Departments of Medicine and Pediatrics, and Division of Laboratory Medicine, Department of
Pathology, Oregon Health Sciences University, Portland, OR

Question 3

A 37-year-old man who was diagnosed with warm AIHA several months ago presents for a follow-up visit. He responded to prednisone therapy but cannot be weaned off steroid therapy as his hemolysis flares whenever his dose is decreased under 20 mg per day. He has also developed diabetes and had a flare of his chronic hepatitis B when he first started high-dose steroids. He is otherwise healthy. What is the next most reasonable option for therapy?

  •   Cyclophosphamide 1000 mg IV every 28 days
  •   Danazol 200 mg 4 times daily
  •   Fludarabine 40 mg/m2 orally days 1–5, 29–34, 57–61, and 85–89
  •   Rituximab at 375 mg/m2 weekly × 4 weeks
  •   Splenectomy

Updated 05/24/2013 • jdw | Copyright ©2013 Turner White Communications