DOI: 10.12890/2024_004780

Mycophenolate mofetil for the treatment of warm autoimmune haemolytic anaemia post-rituximab therapy: a case series

Authors

  • Oscar F. Borja-Montes Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, USA
  • Alejandro Toro-Pedroza Faculty of Health Sciences, Universidad Icesi, Cali, Colombia
  • Darrell D. Horton Department of Pathology, University of New Mexico School of Medicine, Albuquerque, USA
  • Leslie A. Andritsos Hematology and Oncology, UNM Comprehensive Cancer Center, Albuquerque, USA
  • Ala Ebaid Hematology and Oncology, UNM Comprehensive Cancer Center, Albuquerque, USA

oborjamontes@salud.unm.edu

Keywords

Anaemia, haemolytic, autoimmune, rituximab, mycophenolic acid

Abstract

Background: Warm autoimmune haemolytic anaemia (wAIHA) is an acquired haemolytic disorder most commonly treated with a combination of corticosteroids, rituximab and/or splenectomy. Third-line therapies for refractory cases include immunosuppressive agents. Mycophenolate mofetil is frequently used in these scenarios, although its use is supported by small studies and anecdotal evidence rather than large-scale data.
Case description: We describe three cases of refractory warm autoimmune haemolytic anaemia successfully treated with mycophenolate mofetil. Case 1: A persistent case of autoimmune haemolytic anaemia in a 56-year-old was ultimately managed with mycophenolate mofetil, leading to successful steroid tapering and stable haemoglobin levels without relapse. Case 2: A woman with a complex oncological history, including lymphoma and breast cancer, achieved remission with mycophenolate therapy, maintaining stability post-steroid treatment. Case 3: Mycophenolate proved effective for a 63-year-old with cirrhosis after recurrent autoimmune anaemia and deep vein thrombosis, enabling cessation of steroids and maintaining remission.
Conclusion: Management of this condition can be challenging and balancing the available treatments is crucial to reduce potential complications from long-term therapies that appear to be ineffective. Our case series demonstrates anecdotal experience on successful use of mycophenolate mofetil for complex refractory cases of wAIHA.

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Published

2024-08-14

Issue

Vol. 11 No. 9 (2024)

Categories

How to Cite

1.
Borja-Montes OF, Toro-Pedroza A, Horton DD, Andritsos LA, Ebaid A. Mycophenolate mofetil for the treatment of warm autoimmune haemolytic anaemia post-rituximab therapy: a case series. EJCRIM [Internet]. 2024 Aug. 14 [cited 2026 Nov. 4];11(9). Available from: https://ejcrim.com/index.php/ejcrim/article/view/4780

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