Rituximab in the treatment of adult acquired hemophilia A: A systematic review

Rituximab is a monoclonal chimeric antibody to the CD20 antigen, which has proven to be effective in the treatment of non-Hodgkin lymphomas. Recently, rituximab has also been employed in many non-malignant autoimmune disorders (i.e., idiopathic thrombocytopenic purpura, thrombotic thrombocytopenic purpura, connective tissue disorders and autoimmune hemolytic anemia) in which it has been used with the aim of interfering with the production of pathologic antibodies. Moreover, this agent has also shown to be effective in the treatment of acquired antibodies against factor VIII.Through a careful literature search, the current knowledge on rituximab therapy in adult acquired hemophilia A is presented in this review. Although mostly based on uncontrolled studies, the literature data suggest that this drug can be useful in the treatment of disorders of acquired inhibitors to factor VIII. However, large, prospective, randomized trials are needed to confirm these positive preliminary results.