Rituximab + Chemotherapy for AIHA

Overview
Rituximab is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for the treatment of some types of lymphoma, leukemia, and arthritis. Rituximab is sometimes prescribed off-label by doctors for people who have either cold or warm autoimmune hemolytic anemia (AIHA) as an early treatment method. Sometimes, rituximab is combined with chemotherapy agents fludarabine or bendamustine, especially when AIHA presents as a symptom of lymphoma or other forms of blood cancer. Rituximab is also known by its brand name Rituxan.

Rituximab is an immunomodulator, meaning it is a drug that modulates the immune system. It is also considered a biologic. It is a genetically engineered antibody, or protein used by the immune system to identify and neutralize substances. In people with AIHA, rituximab is believed to work by targeting white blood cells that create the antibodies which prematurely destroy red blood cells.

How do I take it?
For AIHA, rituximab + chemotherapy is administered as intravenous infusions in a series of four-week cycles. Infusion usually requires two to four hours each.

Side effects
Common side effects of rituximab include headache, dizziness, fever and chills, nausea, heartburn, and flushed skin.

Rare but serious side effects of rituximab include tumor lysis syndrome, cardiac adverse reactions, kidney toxicity, bowel obstructions, and fetal harm during pregnancy.

Rituximab can cause life-threatening side effects. Rituximab has caused severe infusion reactions and serious infections in some people. In rare cases, rituximab has been linked to a serious brain infection called progressive multifocal leukoencephalopathy. Tell your doctor immediately if you experience neurological symptoms such as confusion, weakness on one side of the body, vision changes, difficulty talking or walking, or trouble concentrating.

Common side effects of both fludarabine and bendamustine include lost appetite, nausea, vomiting, constipation, hair loss, mouth sores, depression, and joint pain.

Rare but serious side effects of fludarabine include severe infection, damage to the nervous system, and lung damage. Check in with your doctor for regular appointments to monitor your body’s response to fludarabine.

Rare but serious side effects of bendamustine include severe infection, reduced production of blood cells, and kidney failure. Check in with your doctor for regular appointments to monitor your body’s response to bendamustine.

You may be more likely to contract infections, including serious infections, due to decreased immune system function while taking rituximab and chemotherapy agents. Contact your doctor if you develop signs of infection such as fever, cough, trouble breathing, white patches in the mouth, pain or burning during urination, or unusual vaginal discharge.

For more details about this treatment, visit:

Rituximab in the Treatment of Autoimmune Hemolytic Anemia — Cancer Network
https://www.cancernetwork.com/view/rituximab-tr...

Rituximab Use in Warm and Cold Autoimmune Hemolytic Anemia — Journal of Clinical Medicine
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC77...

Rituxan (Rituximab) Prescribing Information — U.S. Food and Drug Administration
https://www.gene.com/download/pdf/rituxan_presc...

Cold Agglutinin Disease — NORD
https://rarediseases.org/rare-diseases/cold-agg...

Fludarabine Injection — MedlinePlus
https://medlineplus.gov/druginfo/meds/a692003.html

Bendamustine Injection — MedlinePlus
https://medlineplus.gov/druginfo/meds/a608034.h...