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- Overcoming high pre-transplant isoagglutinin titers using high-dose intravenous immunoglobulin, salvage plasmapheresis, and booster rituximab without splenectomy in ABO-incompatible living donor liver transplantation: a case report
- Hyung Hwan Moon
- Kosin Med J. 2022;37(2):163-168. Published online March 29, 2022
- DOI: https://doi.org/10.7180/kmj.21.036
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- 2 Citations
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- High pre-transplant isoagglutinin is a risk factor for antibody-mediated rejection in ABO-incompatible living donor liver transplantation. A 55-year-old man with alcoholic liver cirrhosis underwent ABO-incompatible living donor liver transplantation. The initial isoagglutinin immunoglobulin G titer was 1:1,024. Despite five sessions of plasmapheresis, the isoagglutinin titer was not significantly reduced (from 1:1,024 to 1:512). We decided to perform 11 plasmaphereses and proceed with liver transplantation regardless of the isoagglutinin titer (1:128 at transplantation day). Instead, we planned to administer 0.5 g/kg intravenous immunoglobulin and booster rituximab (200 mg) after transplant. On postoperative day 6, the isoagglutinin titer increased from 1:32 to 1:64, and the patient received plasmapheresis twice. The patient maintained stable liver function without evidence of further complications or rejection. The high-dose intravenous immunoglobulin, salvage plasmapheresis, and booster rituximab protocol might be able to overcome a pre-transplant high isoagglutinin titer in ABO-incompatible living donor liver transplantation without splenectomy.
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- Fludarabine and Rituximab in Relapsed or Refractory Hairy Cell Leukmia Variant: A Case Report and Review of Literature
- Ji Won Lee, Youn Mi Choi, Jae Yun Yang, Seung Moon Han, Bong Seog Kim, Seung-Hyun Nam
- Kosin Med J. 2018;33(3):438-445. Published online December 31, 2018
- DOI: https://doi.org/10.7180/kmj.2018.33.3.438
- 3,804 View
- 7 Download
- 1 Citations
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Hairy cell leukemia (HCL) is a rare chronic B cell leukemia morphologically characterized by cells with an abundant cytoplasm and hair-like projections that can be found in the peripheral blood and bone marrow. The treatment for HCL is splenectomy or chemotherapy with the purine analogs pentostatin and cladribine. However, patients continue to relapse. Retreatment with the same or alternate purine analogs produces lower response rates and a shorter duration of response. Fludarabine is another purine analog widely used in treating indolent lymphoid cancers, often in combination with rituximab. Here, we report a case of HCL variant in a 60-year-old man who experienced multiple relapses after splenectomy and retreatment with cladribine. The patient was then treated with fludarabine and rituximab combination chemotherapy. After the treatment, he achieved complete remission that continued for 35 months.
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Citations
Citations to this article as recorded by- Long-term clinical outcome of a weekly 2-chlorodeoxyadenosine regimen in treatment-naïve patients with hairy cell leukemia
Ye Eun Oh, Gi-June Min, Young-Woo Jeon, Tong Yoon Kim, Byung-Su Kim, Sung-Soo Park, Silvia Park, Jae-Ho Yoon, Sung-Eun Lee, Byung-Sik Cho, Ki-Seong Eom, Yoo-Jin Kim, Seok Lee, Hee-Je Kim, Chang-Ki Min, Seok-Goo Cho
Annals of Hematology.2025;[Epub] CrossRef
- Long-term clinical outcome of a weekly 2-chlorodeoxyadenosine regimen in treatment-naïve patients with hairy cell leukemia
- Improved Therapeutic Outcomes of Diffuse Large B cell Lymphoma after Introduction of Rituximab in a Single Institution
- Ja Kyung Kim, Yang Soo Kim
- Kosin Med J. 2008;23(4):170-175. Published online December 31, 2008
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