[Ibrutinib treatment for 2 cases of relapsed/refractory autoimmune hemolytic anemia: a pilot study]

L W Fang, H Pan, J Shi, L W Fang, H Pan, J Shi

Abstract

Objective: To explore the efficacy and safety of ibrutinib treatment for relapsed/refractory (R/R) primary autoimmune hemolytic anemia (AIHA) . Methods: Two cases of primary AIHA with relapse events were refractory to glucocorticoid, anti-CD20 monoclonal antibody, immunosuppressive drugs, and splenectomy (case 1 only) . Ibrutinib treatment was administered at an initial dose of 280 mg/d (420 mg/d for case 1 from the 3rd to 8th week) . Results: Both patients achieved transfusion independence and HGB>20 g/L above baseline after 2 weeks (partial response) . For case 1, HGB concentration restored to 113 g/L but with incomplete hemolysis recovery after 10 weeks; HGB reached the level of 118 g/L, also with incomplete hemolysis recovery, after 6 weeks in case 2. They all acquired complete response with incomplete hemolysis recovery (CRi) . The responses sustained 14 weeks and 10 weeks after follow-up at 16 weeks and 12 weeks, respectively. During the treatment, hematologic and nonhematologic toxicity is mild and acceptable. Conclusion: Ibrutinib alone is effective for the 2 R/R primary AIHA cases. We need further clinical trial to identify its efficacy and safety.

Keywords: Autoimmune hemolytic anemia; Ibrutinib; Relapsed/refractory.

Figures

图1. 2例复发/难治原发性自身免疫性溶血性贫血患者伊布替尼治疗后HGB改善情况
图1. 2例复发/难治原发性自身免疫性溶血性贫血患者伊布替尼治疗后HGB改善情况
PR：部分缓解；CRi：完全缓解伴代偿性溶血状态
图2. 2例复发/难治原发性自身免疫性溶血性贫血患者伊布替尼治疗后溶血实验室指标改善情况
图2. 2例复发/难治原发性自身免疫性溶血性贫血患者伊布替尼治疗后溶血实验室指标改善情况

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