Abstract: Objective Standard dose rituximab (375mg/m2/week x 4) has been recommended as salvage regimen for refractory and recurrent warm autoimmune hemolytic anemia (wAIHA). The effect of low-dose rituximab in wAIHA is worth of further study. Method Through a comprehensive literature search through PUBMED and CNKI databases, 13 articles containing 172 cases were included in the systematic review. Result The current understanding of low-dose rituximab in wAIHA is limited. Based on the summary of these studies, the overall response rate was 87.8% with 62.8% complete response and 25% partial response. Since each study only enrolled several cases, the relapse rates markedly varied from 0 to 62.5%. Nevertheless, re-treatment of low-dose rituximab was still effective in some relapsed patients. No significant adverse events were reported. Conclusion Present literature analysis suggests that low-dose rituximab could be an effective and safe therapy for wAIHA. However, large-sized, prospective, randomized trials are needed to further prove these results.

Key words: warm autoimmune hemolytic anemia, rituximab, anti-CD20 monoclonal antibody, low-dose rituximab