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Bortezomib for treatment-refractory autoimmune haemolytic anaemia following multivisceral transplantation
  1. Darren Wong1,2,
  2. William Thomas3,
  3. Andrew Butler4 and
  4. Lisa Sharkey1
  1. 1Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, UK
  2. 2Department of Gastroenterology, Austin Hospital, Heidelberg, Victoria, Australia
  3. 3Department of Haematology, Addenbrooke's Hospital, Cambridge, UK
  4. 4Department of Surgery, Addenbrooke's Hospital, Cambridge, UK
  1. Correspondence to Dr Darren Wong; darren.wong{at}austin.org.au

Abstract

A 25-year-old man who received alemtuzumab as induction therapy for a multivisceral transplant experienced delayed onset of warm autoimmune haemolytic anaemia and neutropaenia. Serological testing and bone marrow biopsy excluded alternative causes. Haemolysis was refractory to standard therapies including corticosteroids, intravenous immunoglobulin and rituximab. The patient was successfully treated with bortezomib, a proteasome inhibitor, and has remained well as an outpatient without evidence of ongoing haemolysis.

  • transplantation
  • haematology (drugs and medicines)
  • GI bleeding

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Footnotes

  • Contributors DW was responsible for drafting the manuscript, literature review, obtaining patient consent and reviewing the manuscript. WT, AB and LS were responsible for planning and conception of the manuscript, as well as critical review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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