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I'm so funny, it must be late, I forgot to include the report for you to read.

Ok, I'll include it here.

K.

Report for your consideration :

Well, now I can't find the damn thing. & $@#%

I'll find it and put it up for you later tonight or tomorrow , I hope

everyone has a wonderful weekend, talk later, K.

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Hey ,

I finally found it, I thought you would find it interesting.

Kurt

Clin Lab Haematol. 2006 Feb;28(1):57-9.

Treatment of refractory fludarabine induced autoimmune haemolytic

with the anti-cd20 monoclonal antibody rituximab.

Swords R, Nolan A, Fay M, Quinn J, O'donnell R, PT.

Department of Haematology, Beaumont Hospital, Dublin, Ireland.

A patient with cold-type autoimmune haemolytic anaemia for 8 years

developed progressive B cell chronic lymphocytic leukaemia (CLL).

Despite the risk of fludarabine induced exacerbation of haemolysis,

he was given aggressive anti-CLL therapy with six courses of FCR

(fludarabine 25 mg/m(2) D1-3, cyclophosphamide 250 mg/m(2) D2-4 and

rituximab 375 mg/m(2) D1) every 4 weeks. This resulted in a marked

acute increase in haemolysis shortly after completing each course of

fludarabine. However, haemolysis had settled to its baseline level by

the time of subsequent courses of FCR.

FCR resulted in complete clinical remission of CLL but residual

haemolysis persisted. The patient was then given four weekly

infusions of single agent rituximab, resulting in ongoing remission

of haemolysis.

In this patient, rituximab appears to have controlled fludarabine-

induced exacerbation of autoimmune haemolysis. In addition,

subsequent single agent rituximab therapy resulted in prolonged

remission of cold-type autioimmune haemolytic anaemia.

It remains to be seen if the addition of rituximab will allow other

patients with a positive direct Coomb's test and/or autoimmune

haemolysis to receive fludarabine containing chemotherapy without

undue risk of life-threatening haemolytic anaemia.

PMID: 16430461 [PubMed - in process]

-------------- Original message ----------------------

From: thel.g@...

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