علاج الخط الأول لفقر الدم الانحلالي المناعي الذاتي الدافئ

DOI: 10.1182/hematology.2022000405

• Corticosteroids are the initial therapy for almost all patients (Table 4).
• Prednisone at 1mg/kg/d for 2 to 4 weeks until the Hgb level is over 10 is a common starting dose.
• Slow steroid tapering over 5 to 12 weeks to the lowest effective dose is then undertaken, with close monitoring (every 1-2 weeks) of Hgb, reticulocyte count, LDH, and haptoglobin.
• All patients should be supplemented with folic acid of at least 0.4mg/d and repleted with B12 and iron if so deficient.
• In medically unstable, symptomatic patients, particularly those with Hgb levels lower than 6g/dL, RBC transfusion is indicated.
• Over 85% of patients have a rise in Hgb.
• Successful therapy strives for a stable Hgb level over 10g/dL, resolution of symptoms, and transfusion independence.