Sirolimus – alternative treatment for warm antibody hemolytic anaemia (WAIHA)
Authors:
V. Fiamoli 1; J. Blatný 1; A. Pejchalová 2; O. Zapletal 1; S. Köhlerová 1
Authors‘ workplace:
Oddělení dětské hematologie DN FN Brno
1; Transfuzní a tkáňové oddělení FN Brno
2
Published in:
Transfuze Hematol. dnes,25, 2019, No. 3, p. 264-268.
Category:
Case Reports
Overview
Autoimmune haemolytic anaemia caused due to accelerated destruction of red cells by warm IgG auto-antibodies and activated complement is a rare disease in the paediatric population. It can be life-threatening if resistant to treatment. Corticosteroids lead to complete remission in 80 % of children. Sirolimus is a recently available second-line therapeutic option. We describe the case reports of three patients with autoimmune haemolytic anaemia and warm antibodies in whom sirolimus had a very good effect.
Keywords:
body mass index – WAIHA – sirolimus
Sources
1. Silberstein LE, Cunningham MJ. Autoimmune hemolytic anemias. In: Hillyer, Christopher D. Blood banking and transfusion medicine: basic principles & practice. Philadelphia, PA: Churchill Livingstone/Elsevier, 2007:557–570.
2. Aladjidi N, Leverger G, Leblanc T, et al. New insights into childhood autoimmune haemolytic anemia: a French national observational study of 265 children. Haematologica 2011;96:655–663.
3. Vagace JM, Bajo R, Gervasini G. Diagnostic and theurapeutic challenges of primary autoimmune haemolytic anemia in children. Arch Dis Child 2014;99:668–673.
4. Chen RT, Pless R, Destefano F. Epidemiology of autoimmune reactions induced vaccination. J Autoimmun 2001;16(3):309–318.
5. Zanella A, Barcellini W. Treatment of autoimmune hemolytic anemias. Haematologica 2014;99(10):1547–1554.
6. Miano M. How I manage Evans syndrome and AIHA cases in children. Br J Haematol 2016;172(4):524–534.
7. Buliková A. Extrakorpuskulární hemolytické anemie. In: Penka M, Bulikova A a kolektiv. Neonkologická hematologie, 2. doplněné a zcela přepracované vydání. Praha, Grada 2009;78–91.
8. Mathew P, Chen G, Wang W. Evans syndrome: results of a national survey. J Pediatr Hematol Oncol 1997;19(5):433–437.
9. Seidel GM. Autoimmune and other cytopenias in primary immunodeficiencies: pathomechanism, novel differential diagnoses, and treatment. Blood 20014;124:2337–2344.
10. Svaton M, Sukova M, Hložková K. Imunitní dysregulace a imunitní cytopenie na podkladě vrozené mutace v TLR8. XXVIII. konference dětských hematologů a onkologů České a Slovenské republiky. Sborník abstrakt 2018;47.
11. Heisel MA, Ortega JA. Factors influencing prognosis in childhood autoimmune hemolytic anemia. Am J Pediatr Hematol Oncol 1983;5(2):147–152.
12. Zecca M, Nobili B, Ramenghi U, et al. Rituximab for the treatment of refractory autoimmune hemolytic anemia in children. Blood 2003;101(10):3857–3861.
13. King KE, Ness PM. Treatment of autoimmune hemolytic anemia. Semin Hematol 2005;42:131–136.
14. Norton A, Roberts I. Management of Evans syndrome. Br J Haematol 2006;132(2):125–137.
15. Michel M. Classification and therapeutic approaches in autoimmune hemolytic anemia: an update. Expert Rev Hematol 2011;4(6):607–618.
16. Seto B. Rapamycin and mTOR: a serendipitous discovery and implications for breast cancer. Clin Translat Med; 2012;1:29. Publikováno elektronicky 15 listopadu 2012; doi:10.1186/2001-1326-1-29.
17. Pritchard DI. Sourcing a chemical succession for cyclosporin from parasites and human pathogens. Drug Discovery Today 2005;10(10):688–691.
18. Zhan P, TEY SK, Koyama M, et al. Induced regulatory T cells promote tolerance when stabilized by Rapamycin and IL-2 in vivo. Immunology 2013;191:5291–5303.
19. http://www.sukl.cz/modules/medication/detail.php?code=0027243&tab=texts
20. http://iweb3.fnusa.cz/wp-content/uploads/2018/05/Laboratorni_prirucka_LOKB_verze_12_2018_vytisk_c4.pdf
21. Miano M, Calvillo M, Palmisani E, et al. Sirolimus for the treatment of multi-resistant autoimmune haemolytic anaemia in children. Br J Haematol 2014;167(4):571–574.
22. Miano M, Scalzone M, Perri K, et al. Mycophenolate mofetil and Sirolimus as second or further line treatment in children with chronic refractory Primitive or Secondary Autoimmune Cytopenias: a single centre experience. Br J Haematol 2015;171(2):247–253.
23. Valentini R, Imam A, Warrier I, et al. Sirolimus rescue for tacrolimus-associated post-transplant autoimmune hemolytic anemia. Ped Transplant 2006;10(3):358–361.
24. Park JA, Lee HH, Kwon HS, et al. Sirolimus for refractory autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation: a case report and literature review of the treatment of post-transplant autoimmune hemolytic anemia. Transfus Med Rev 2016;30(1):6–14.
25. Seltsam A, Shukry-Schulz S, Salama A. Vaccination-associated immune hemolytic anemia in two children. Transfusion 2000;40(8):907–909.
Labels
Haematology Internal medicine Clinical oncologyArticle was published in
Transfusion and Haematology Today
2019 Issue 3
Most read in this issue
- Osteonecrosis of the jaw, atypical fractures and other less frequent adverse events associated with bisphosphonates
- Revaccination of adult patients following allogeneic haematopoietic stem cell transplantation: CELL recommendations
- Pharmacokinetics in haemophilia treatment
- Sirolimus – alternative treatment for warm antibody hemolytic anaemia (WAIHA)