Rituximab treatment for relapsed autoimmune hemolytic anemia in Evans syndrome

A case is reported of idiopathic relapsed autoimmune hemolytic anemia successfully treated with rituximab. A 43-year-old white male patient with past medical history of Evans syndrome was found to have recurrent autoimmune hemolytic anemia. Previous treatments included steroids, splenectomy, intravenous immunoglobulin, plasmapheresis, staphylococcal Protein A immunoadsorption (Prosorba column), and chemotherapeutic agents (cytoxan and vincristine). Rituximab was given weekly at 375 mg/m2 for 4 doses. The drug was well tolerated and the patient remains in remission 9 months after completion of therapy.