How do you treat refractory cold agglutinin disease?
The patient who has not responded to steroids, rituximab/bendamustine, and splenectomy?
Answer from: Medical Oncologist at Academic Institution
If the patient has refractory cold agglutinin disease not associated with malignant lymphoproliferative disease, I have used intermediate dose Cytoxan. However, there is recent evidence that inhibition of C1s and thus complement activation by a monoclonal antibody sutimlimab markedly reduces h...
Answer from: Medical Oncologist at Community Practice
Some options include the following: 1. Bortezomib has about a 32% ORR described in this 2018 study (Blood). The study only gave one cycle of therapy which seems quite short, and in practice, I would consider giving at least 3 before deeming a patient refractory.2. Different rituximab chemo comb...