Shirley D’Sa: Chemoimmunotherapy in Cold Agglutinin Disease and WM-Associated CAS
Shirley D’Sa, Professor of Haematology at UCL Cancer Institute, Advisory Council Member at Harvard Business Review, shared a post on LinkedIn about a recent article by
Kenichi Ito et al, published in Frontiers in Medicine, adding:
“Cold agglutinin-associated hemolysis does not always fit neatly into our diagnostic boxes.
This new study by colleagues in Japan examines rituximab-based chemoimmunotherapy in patients with primary cold agglutinin disease and Waldenström macroglobulinemia-associated cold agglutinin syndrome.
Despite their differing underlying classifications, hematological responses were seen in both groups—100 percent in primary CAD and 80 percent in WM-associated disease—with no apparent difference in time to next treatment.
The study is small, retrospective and hypothesis-generating, but it raises a clinically relevant question:
When hemolysis is the dominant problem and precise classification remains difficult—particularly in MYD88-negative cases—might fixed-duration, clone-directed chemoimmunotherapy remain a pragmatic treatment option?
Modern diagnostic precision matters, but treatment must also address the biology causing harm to the patient.
An interesting contribution to an area in which larger, collaborative studies are much needed.
Read the open-access article: The impact of chemoimmunotherapy on primary cold agglutinin disease and Waldenström macroglobulinemia-associated cold agglutinin syndrome.”
Title: The impact of chemoimmunotherapy on primary cold agglutinin disease and Waldenström macroglobulinemia-associated cold agglutinin syndrome
Authors: Kenichi Ito, Tomoko Kitagawa, Saya Motohashi, Kazuhiko Hirano, Naohiro Sekiguchi

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