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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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| 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. |
| format | Article |
| id | doaj-art-efb64b627df14bfb98597f7e9456516a |
| institution | Kabale University |
| issn | 1607-8454 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| 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 |
| work_keys_str_mv | AT taowang splenectomyfollowingrituximabandcyclophosphamideforsevereautoimmunehemolyticanemiainpregnancy AT juanyang splenectomyfollowingrituximabandcyclophosphamideforsevereautoimmunehemolyticanemiainpregnancy AT bingpeng splenectomyfollowingrituximabandcyclophosphamideforsevereautoimmunehemolyticanemiainpregnancy AT yongqianjia splenectomyfollowingrituximabandcyclophosphamideforsevereautoimmunehemolyticanemiainpregnancy AT hongbingma splenectomyfollowingrituximabandcyclophosphamideforsevereautoimmunehemolyticanemiainpregnancy |