Table 2.
Effect of ES As on hemolysis in patients with WAIHA and CAIHA
| Patient no. | Treatment | Erythropoietin | Prior to /1–2 weeks after treatment with ESAs* | ||||||
|---|---|---|---|---|---|---|---|---|---|
| previously | currently | preparation | dose (within) | Hb, g/dl | retis, % | LDH, U/l | Bili, mg/dl | last medication | |
| 1 | P, D, C, A, M, R, Bit | P+ | Aranesp® | 20× 20 µg/(4w) | 9.2/11.7 | 53/2.9 | 414/322 | 1.5/1.2 | P (7.5 mg/day) |
| 2 | P, D, C, IVIG, Blt (n = 43) | C, P | Aranesp® | 2× 500 µg/(1w) | 5.0/12.7 | 6.4/13 | 718/192 | 2.41/0.39 | C (50 mg/day) |
| 3 | P,C, Bend, Blt, IV IgG | EPO® | 4× 20,000 IU/(2w) | 11.3/12.9 | 18.7/27.3 | 248/306 | 0.8/0.8 | - | |
| 4 | P, D, C, Bit (n=38) | P, C | E-poietin® | 5× 40,000 IU/(3w) | <7.0/15.0 | 4.8/6.0 | 779/204 | 8.8/0.86 | - |
| D | P+ | E-poietin® | 1× 40,000 IU | 8.9/13.3 | n.t. | 613/283 | n.t. | P (10 mg/day) | |
| 5 | P, A, C, D, M | P+ | Silapo® | 12× 40,000 IU/(2y) | 7.9/10.5 | 3.3/13 | 392/233 | 1.1/0.32 | P (5 mg/day) |
| 6 | P, A, R, Blt | C, Blt | Silapo® | 3× 40,000 IU/(2w) | 8.9/11.5 | 11.4/4.7 | 429/351 | 2.3/0.97 | C (100 mg/day) |
| 7 | D, Blt, C, P | C, P, Blt | EPO® | 2× 20,000 U/(1w) | 8.6/12.4 | 10.8/4.5 | 611/353 | 1.24/0.37 | C (50 mg/day), P (15 mg/day) |
| 8 | P, A, Blt | P, A | EPO® | 3× 20,000 IU/(2w) | 5.2/8.4 | 7.07/7.86 | 308/310 | /2.86 | – |
| 9 | IVIgG, Blt | Silapo® | 2× 40,000 IU/(1w) | 8.5/7.3 | 6.5/8.3 | 1,294/1,396 | 1.9/2.4 | – | |
| IVIgG | Silapo® | 2× 40,000 IU/(1w) | 8.5/11.0 | S.2/3.2 | 1,396/419 | 23/1.1 | – | ||
| 10 | Blt | E-poietin® | 1× 10,000 IU | 8.6/9.2 | n.t/3.4 | n.t. | n.t. | – | |
| 11 | P, A, C, Blt | Blt | EPO® | 2× 20,000 U/(1w) | 9.0/10.6 | 3.5/5.0 | 717/359 | 2.29/2.9 | – |
| 12 | Silapo® | 2× 20,000 U/(1w) | 8.7/9.9 | 4.5/5.9 | 388/795 | 1.62/2.89 | – | ||
Bili = Total bilirubin; retis = reticulocytes; HP = haptoglobin; CR = creatinine; w = week; P = prednisolone; D = Dexamethasone; C = cyclophosphamide; A = azathioprine; M = mycophenolate moftefil; R = rituximab; Blt = red blood transfusion; Bend = bendamustin; y = year.
*
Haptoglobin was undetecable in all cases prior to treatment with EPO, and increased to normal value only in two cases following treatment with EPO (patients nos. 4, 5) + low dose (= 10 mg/day). Creatinine was increased only in patient no 1 (1.4 mg/dl) prior to treatment with EPO, and has been normalized (1.01 mg/dl) thereafter.