Is Splenectomy still the best treatment for Autoimmune hemolytic anemia
DOI:
https://doi.org/10.12775/JEHS.2023.46.01.010Keywords
Autoimmune hemolytic anemia, aiha, Splenectomy, RituximabAbstract
Introduction:
Autoimmune hemolytic anemia (AIHA) is an acquired, heterogeneous group of diseases that includes AIHA with warm type antibodies, cold agglutinin disease (CAD), mixed type AIHA, paroxysmal cold hemoglobinuria, and atypical AIHA.
Currently CAD is defined as chronic, clonal lymphoproliferative disease, while presence of cold agglutinin in gastrointestinal tract is known as cold agglutinin syndrome. AIHA is mediated by autoantibodies against red blood cells (RBCs), these antibodies cause premature destruction of erythrocytes. The pathogenesis of AIHA is complex and still not yet fully understood.
Aim of study:
The purpose of the study was to review the literature on the treatment options for Autoimmune Hemolytic Anemia
Materials and methods: A systemic review was conducted using PubMed, ScienceDirect, Google Scholar databases. The search strategy was based on following terms: Aiha, splenectomy autoimmune anemia, aiha treatment,
Results and Conclusions:
Based on the review of the medical literature, we believe that Splenectomy is no longer the most effective method of treating any type of AIHA and the Rituximab treatment presented by us seems to be safer and definitely less burdensome for the patient.
Of course, splenectomy is still used in AIHA - but nowadays it is more limited due to the very high effectiveness of the described non-surgical treatment
References
Michalak SS, Olewicz-Gawlik A, Rupa-Matysek J, Wolny-Rokicka E, Nowakowska E, Gil L. Autoimmune hemolytic anemia: current knowledge and perspectives. Immun Ageing. 2020 Nov 20;17(1):38. Doi: 10.1186/s12979-020-00208-7. PMID: 33292368; PMCID: PMC7677104.
Hansen DL, Möller S, Andersen K, Gaist D, Frederiksen H. Increasing incidence and prevalence of acquired hemolytic Anemias in Denmark, 1980-2016. Clin Epidemiol. 2020;12:497–508. doi: 10.2147/CLEP.S250250, z czego wAIHA jest najczęstszą postacią i odpowiada za około 2/3 przypadków . Packman CH. Hemolytic anemia due to warm autoantibodies. Blood Rev. 2008;22(1):17–31. doi: 10.1016/j.blre.2007.08.001
Berentsen S, Röth A, Randen U, Jilma B, Tjønnfjord GE. Cold agglutinin disease: current challenges and future prospects. J Blood Med. 2019;10:93–103. doi: 10.2147/JBM.S177621
Barcellini W, Fattizzo B, Zaninoni A. Management of refractory autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation: current perspectives. J Blood Med. 2019;10:265–278. doi: 10.2147/JBM.S190327.
Barcellini W, Fattizzo B. The Changing Landscape of Autoimmune Hemolytic Anemia. Front Immunol. 2020 Jun 3;11:946. doi: 10.3389/fimmu.2020.00946. PMID: 32655543; PMCID: PMC7325906.
Carroll B, Phillips E (1991) Laparoscopic splenectomy. Surg Endosc 6:183-185
Cuschieri A, Shimi S, Banting S, Vander Valpen G (1992) Technical aspects of laparoscopic splenectomy: hilar segmental devascularization and instrumentation. J R ColI Surg Edinb 37(6):414-416
Thibault C, Mamazza J, Letourneau R, Poulin E (1992) Laparoscopic splenectomy: operative technique and preliminary report. Surg Laparosc Endosc 2(3):248-253
Delaitre B, Maignien B (1992) Laparoscopic splenectomy - technical aspects. Surg Endosc 6:305-308
Working Party of the British Committee for Standards in Haematology Clinical Haematology Task Force (February 1996). "Guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen". BMJ. 312 (7028): 430–4. doi:10.1136/bmj.312.7028.430. PMC 2350106. PMID 8601117.
Tarantino G, Scalera A, Finelli C (June 2013). "Liver-spleen axis: intersection between immunity, infections and metabolism". World Journal of Gastroenterology. 19 (23): 3534–42. doi:10.3748/wjg.v19.i23.3534. PMC 3691032. PMID 23801854
Kolata G (9 November 2004). "A Diabetes Researcher Forges Her Own Path to a Cure". The New York Times.
Kruetzmann S, Rosado MM, Weber H, Germing U, Tournilhac O, Peter HH, Berner R, Peters A, Boehm T, Plebani A, Quinti I, Carsetti R (April 2003). "Human immunoglobulin M memory B cells controlling Streptococcus pneumoniae infections are generated in the spleen". The Journal of Experimental Medicine. 197 (7): 939–45. doi:10.1084/jem.20022020. PMC 2193885. PMID 12682112.
Salles G, Barrett M, Foà R, Maurer J, O'Brien S, Valente N, Wenger M, Maloney DG. Rituximab in B-Cell Hematologic Malignancies: A Review of 20 Years of Clinical Experience. Adv Ther. 2017 Oct;34(10):2232-2273. doi: 10.1007/s12325-017-0612-x. Epub 2017 Oct 5. PMID: 28983798; PMCID: PMC5656728.
Heidel F, Lipka DB, von Auer C, Huber C, Scharrer I, Hess G. Addition of rituximab to standard therapy improves response rate and progression-free survival in relapsed or refractory thrombotic thrombocytopenic purpura and autoimmune haemolytic anaemia. Thromb Haemost. 2007;97:228–233.
Leandro M, Isenberg DA. Rituximab - The first twenty years. Lupus. 2021 Mar;30(3):371-377. doi: 10.1177/0961203320982668. Epub 2021 Jan 17. PMID: 33459161.
.Carson KR, Evens AM, Richey EA, Habermann TM, Focosi D, Seymour JF, Laubach J, Bawn SD, Gordon LI, Winter JN, Furman RR, Vose JM, Zelenetz AD, Mamtani R, Raisch DW, Dorshimer GW, Rosen ST, Muro K, Gottardi-Littell NR, Talley RL, Sartor O, Green D, Major EO, Bennett CL. Progressive multifocal leukoencephalopathy after rituximab therapy in HIV-negative patients: a report of 57 cases from the Research on Adverse Drug Events and Reports project. Blood. 2009 May 14;113(20):4834-40. doi: 10.1182/blood-2008-10-186999. Epub 2009 Mar 5. PMID: 19264918; PMCID: PMC2686134.
Murakhovskaya I. Rituximab Use in Warm and Cold Autoimmune Hemolytic Anemia. J Clin Med. 2020 Dec 13;9(12):4034. doi: 10.3390/jcm9124034. PMID: 33322221; PMCID: PMC7763062.
Dierickx D, Kentos A, Delannoy A. The role of rituximab in adults with warm antibody autoimmune hemolytic anemia. Blood. 2015 May 21;125(21):3223-9. doi: 10.1182/blood-2015-01-588392. Epub 2015 Mar 31. PMID: 25827833.
Hematology Am Soc Hematol Educ Program. 2022 Dec 9;2022(1):105-113. doi: 10.1182/hematology.2022000405. PMID: 36485114; PMCID: PMC9821065.
Cold Agglutinin Disease. In: Papadakis MA, McPhee SJ, Bernstein J. eds. Quick Medical Diagnosis & Treatment 2022. McGraw Hill; 2022. Accessed May 15, 2023. https://accessmedicine.mhmedical.com/content.aspx?bookid=3109§ionid=261297259
Okamoto S, Urade T, Yakushijin K, Kido M, Kuramitsu K, Komatsu S, Gon H, Yamashita H, Shirakawa S, Tsugawa D, Terai S, Yanagimoto H, Toyama H, Fukumoto T. Successful Management of Refractory Autoimmune Hemolytic Anemia with Cold Agglutinin Disease with Splenectomy: A Case Report with Review of Literature. Kobe J Med Sci. 2023 Jan 11;68(1):E30-E34. PMID: 36647084; PMCID: PMC10117625.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Aleksandra Puszkarz, Malwina Chomicz, Anna Łukaszewska, Ewa Łukaszewska, Mateusz Bąk, Natalia Guzik, Tomasz Bik, Łukasz Gaj, Katarzyna Drozdowska, Katarzyna Łukaszewska-Stanik
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 340
Number of citations: 0