Experimental Treatments for Cold Agglutinin Disease

Overview

No treatment is necessary in mild cases of cold agglutinin disease. Avoiding cold temperatures or living in regions with warmer climates can help to prevent the binding of autoantibodies to red blood cells. Folic acid supplements are also advisable because this vitamin is essential for the formation of red blood cells. Several treatment options are used in severe cases of CAD. New experimental therapies are being developed, such as those summarized below.

Erythropoietin

Erythropoietin (EPO) is a hormone produced by the kidneys that helps in the production of red blood cells. The administration of EPO could help the body produce more red blood cells to compensate for their loss in severe forms of CAD. Excessive use of EPO, however, can lead to conditions associated with a rapid rise in hemoglobin concentrations, including cardiovascular events and blood clots.

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Rituximab

Rituximab is used as a first-line treatment for CAD and is effective as a monotherapy in about half of all cases. It is an antibody that binds to the immune cells that produce autoantibodies. With fewer autoantibodies around to bind to red blood cells, there’s less clumping of these blood cells and fewer immune attacks.

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