Splenectomy following rituximab and cyclophosphamide for severe autoimmune hemolytic anemia in pregnancy

Autoimmune hemolytic anemia (AIHA) in pregnancy is uncommon and intractable when it becomes steroid-refractory. Due to lacking well-established guidelines for AIHA in pregnancy, a balance must be weighed between benefits and risks. It is unlikely to undergo clinical trials to investigate the obstetr...

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Main Authors: Tao Wang, Juan Yang, Bing Peng, Yongqian Jia, Hongbing Ma
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Hematology
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Online Access:https://www.tandfonline.com/doi/10.1080/16078454.2025.2516885
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author Tao Wang
Juan Yang
Bing Peng
Yongqian Jia
Hongbing Ma
author_facet Tao Wang
Juan Yang
Bing Peng
Yongqian Jia
Hongbing Ma
author_sort Tao Wang
collection DOAJ
description Autoimmune hemolytic anemia (AIHA) in pregnancy is uncommon and intractable when it becomes steroid-refractory. Due to lacking well-established guidelines for AIHA in pregnancy, a balance must be weighed between benefits and risks. It is unlikely to undergo clinical trials to investigate the obstetric outcomes of treatments that may have potential toxicities to the fetus. Therefore, observational cases play a critical role in accumulating experience for this minor population. In this report, we describe a pregnant with a history of AIHA for 10 years. The hemolysis was exacerbated during gestation with very severe anemia and increasing splenomegaly, showing no response to glucocorticoid, immunoglobulin, rituximab and high-dose cyclophosphamide. The patient underwent a successful splenectomy and delivered a normal neonate except for low weight. In the follow-up of 2 years, the underlying disease emerged as systemic lupus erythematosus, and the child grew up healthily with a routine immunization schedule.
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publisher Taylor & Francis Group
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series Hematology
spelling doaj-art-efb64b627df14bfb98597f7e9456516a2025-08-20T03:45:14ZengTaylor & Francis GroupHematology1607-84542025-12-0130110.1080/16078454.2025.2516885Splenectomy following rituximab and cyclophosphamide for severe autoimmune hemolytic anemia in pregnancyTao Wang0Juan Yang1Bing Peng2Yongqian Jia3Hongbing Ma4Hematology Department, West China HospitalSichuan University, Chengdu, People’s Republic of ChinaHematology Department, West China HospitalSichuan University, Chengdu, People’s Republic of ChinaDepartment of Pancreatic Surgery, West China Hospital, Sichuan University, People’s Republic of ChinaHematology Department, West China HospitalSichuan University, Chengdu, People’s Republic of ChinaHematology Department, West China HospitalSichuan University, Chengdu, People’s Republic of ChinaAutoimmune hemolytic anemia (AIHA) in pregnancy is uncommon and intractable when it becomes steroid-refractory. Due to lacking well-established guidelines for AIHA in pregnancy, a balance must be weighed between benefits and risks. It is unlikely to undergo clinical trials to investigate the obstetric outcomes of treatments that may have potential toxicities to the fetus. Therefore, observational cases play a critical role in accumulating experience for this minor population. In this report, we describe a pregnant with a history of AIHA for 10 years. The hemolysis was exacerbated during gestation with very severe anemia and increasing splenomegaly, showing no response to glucocorticoid, immunoglobulin, rituximab and high-dose cyclophosphamide. The patient underwent a successful splenectomy and delivered a normal neonate except for low weight. In the follow-up of 2 years, the underlying disease emerged as systemic lupus erythematosus, and the child grew up healthily with a routine immunization schedule.https://www.tandfonline.com/doi/10.1080/16078454.2025.2516885Autoimmune hemolytic anemiapregnancyrituximabcyclophosphamidesplenectomy
spellingShingle Tao Wang
Juan Yang
Bing Peng
Yongqian Jia
Hongbing Ma
Splenectomy following rituximab and cyclophosphamide for severe autoimmune hemolytic anemia in pregnancy
Hematology
Autoimmune hemolytic anemia
pregnancy
rituximab
cyclophosphamide
splenectomy
title Splenectomy following rituximab and cyclophosphamide for severe autoimmune hemolytic anemia in pregnancy
title_full Splenectomy following rituximab and cyclophosphamide for severe autoimmune hemolytic anemia in pregnancy
title_fullStr Splenectomy following rituximab and cyclophosphamide for severe autoimmune hemolytic anemia in pregnancy
title_full_unstemmed Splenectomy following rituximab and cyclophosphamide for severe autoimmune hemolytic anemia in pregnancy
title_short Splenectomy following rituximab and cyclophosphamide for severe autoimmune hemolytic anemia in pregnancy
title_sort splenectomy following rituximab and cyclophosphamide for severe autoimmune hemolytic anemia in pregnancy
topic Autoimmune hemolytic anemia
pregnancy
rituximab
cyclophosphamide
splenectomy
url https://www.tandfonline.com/doi/10.1080/16078454.2025.2516885
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AT juanyang splenectomyfollowingrituximabandcyclophosphamideforsevereautoimmunehemolyticanemiainpregnancy
AT bingpeng splenectomyfollowingrituximabandcyclophosphamideforsevereautoimmunehemolyticanemiainpregnancy
AT yongqianjia splenectomyfollowingrituximabandcyclophosphamideforsevereautoimmunehemolyticanemiainpregnancy
AT hongbingma splenectomyfollowingrituximabandcyclophosphamideforsevereautoimmunehemolyticanemiainpregnancy