Efficacy and safety of splenectomy in adult autoimmune hemolytic anemia
Giudice Valentina,
Rosamilio Rosa,
Ferrara Idalucia,
Seneca Elisa,
Serio Bianca,
Selleri Carmine
Affiliations
Giudice Valentina
Hematology and Transplant Center, Department of Medicine and Surgery, University of Salerno, Salerno, 84131, Italy
Rosamilio Rosa
Hematology and Transplant Center, Department of Medicine and Surgery, University of Salerno, Salerno, 84131, Italy
Ferrara Idalucia
Hematology and Transplant Center, Department of Medicine and Surgery, University of Salerno, Salerno, 84131, Italy
Seneca Elisa
Hematology and Transplant Center, Department of Medicine and Surgery, University of Salerno, Salerno, 84131, Italy
Serio Bianca
Hematology and Transplant Center, Department of Medicine and Surgery, University of Salerno, Salerno, 84131, Italy
Selleri Carmine
Hematology and Transplant Center, Department of Medicine and Surgery, University of Salerno, Salerno, 84131, Italy, Tel. +39 089673150, mobile: 335616659
Autoimmune hemolytic anemia (AIHA) is a rare hematologic disease, primarily affecting adults or children with immunodeficiency disease. First-line therapy consists of long course of steroids administration, with an early complete response rate (CRr) of 75-80%, but up to 20-30% of patients requires a second-line therapy. Rituximab is the first choice in refractory old AIHA patients, because of its safety and efficacy (early CRr at 80-90% and at 68% at 2-3 years). For this reason, splenectomy is even less chosen as second-line therapy in elderly, even though laparoscopic technique decreased complication and mortality rates. However, splenectomy can be still considered a good therapeutic option with a CRr of 81% at 35.6 months in patients older than 60 year-old, when rituximab administration cannot be performed.
