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Bleeding and Clotting Disorders

Use of Rituxin for cold agglutin hemolytic an

10/01/2007

Question:

I have severe Cold Agglutin Hemolytic Anemia and now 72. My body is having more & more difficulty keeping up the the constant hemolysis. My hematocrits have dropped to 16.9 and 19 in the past two months & I have had to have 3 transfusions in the past 4 months. My hematologist is suggesting a course of iv infusion of Rituxin. 1. Is it advisable???? It hasn`t yet been approved for this diagnosis as there are so few people to study with this life-threatening disease. 2. If it is, how can I get Medicare to pay for it? I`d be so grateful for any help. Thank you for your consideration.

Answer:

While it is difficult to answer detailed questions specific to your condition without more information, rituximab has been used to treat certain hemolytic anemias. Although it is not FDA approved, there are many uses for the drug that fall outside of the indications that the FDA has approved for the drug. Although it is reasonable to use the drug for hemolytic anemias, it is hard to make any more specific recommendations without knowing more about your cases and examining you.

I would make sure you talk to your physician to find out why he or she wants to use this drug and if there are any other alternatives so you know the options that may be available to treat your disease.

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Response by:

Spero R Cataland, MD Spero R Cataland, MD
Associate Professor of Clinical Internal Medicine
College of Medicine
The Ohio State University