When would you consider splenectomy or other immunosuppressive/cytotoxic therapy for steroid-refractory warm autoimmune hemolytic anemia?

For example, in a patient who is steroid-refractory, requiring regular transfusion, and has not had response to rituximab after several weeks.

Answer from: at Academic Institution

If it is refractory to prednisone, my next approach is Rituxan. If it fails to respond to Rituxan, I have had luck with Daratumumab. I avoid splenectomy since the response rate is no better than 30%.

Comments

at University of Washington
It is somewhat dependent on the patient demographi...

Medical Oncologist at Locum Tenens
Thanks.

at Dana-Farber Cancer Institute
I agree with Dr. @Joseph H. Antin and the subseque...

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When would you consider splenectomy or other immunosuppressive/cytotoxic therapy for steroid-refractory warm autoimmune hemolytic anemia?

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