Progress in diagnosis and treatment of autoimmune hemolytic anemia

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  • 自己免疫性溶血性貧血の診療
  • 自己免疫性溶血性貧血の診療 : 最近の動向
  • ジコ メンエキセイ ヨウケツセイ ヒンケツ ノ シンリョウ : サイキン ノ ドウコウ
  • —最近の動向—

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Abstract

<p>In 2017, The British Society of Haematology published new guidelines for the diagnosis and management of autoimmune hemolytic anemia (AIHA). Usually this is diagnosed using a combination of clinical and laboratory findings of hemolysis using the direct antiglobulin test (DAT). The revised guidelines propose several steps to evaluate and diagnose patients with unexplained hemolysis and a negative DAT, and they recommend screening for cold agglutinin disease (CAD) using a direct agglutination test (DAggT) before evaluating the cold agglutinin titer. Rituximab is becoming the preferred second-line choice for steroid-refractory warm AIHA and the first-line choice for primary CAD. Rituximab is an off-label drug for use in AIHA treatment in Japan, but in future will be used as standard therapy. Anti-C1s antibody is a new drug for CAD that has entered phase 3 trials.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 60 (9), 1100-1107, 2019

    The Japanese Society of Hematology

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