Autoimmune Hemolytic Anemia Clinical Trial
Official title:
Tacrolimus Treatment for Refractory Autoimmune Cytopenia
Autoimmune cytopenia, including autoimmune hemolytic anemia (AIHA), pure red cell aplasia (PRCA), Evans syndrome (ES), usually has good responses to steroids therapies as first line, but there is a considerable percentage of patients who relapse, become refractory or dependent on steroids to maintain an acceptable level of hemoglobin or platelets. The effects of the second line therapy are also not satisfactory and sometimes not available. The investigators aim to explore the efficacy and side-effect of tacrolimus for refractory autoimmune cytopenia.
Tacrolimus binds FKBP12 with high affinity after entry into cytoplasm, suppresses calcineurin
activity and prevents nuclear translocation of transcription factors such as NF-AT that are
involved in IL-2 gene transcription. As a result, T-cell activation is inhibited with a
subsequent reduction in the production of cytokines that include IL-2, TNF-α, IL-3, IL-4,
IFN-γ, IL-6 and IL-10; B-cell activation, class-switching and immunoglobulin production are
also attenuated. Reports on the use of tarcrolimus in the treatment of autoimmune cytopenia
are anecdotal and describe therapy with a variety of drug dosages.
The purpose of this study is to evaluate the effect of tacrolimus on patients with refractory
autoimmune cytopenia, the side-effects will be documented and plasma concentration of
tacrolimus will be monitor.
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