{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T23:50:39Z","timestamp":1788393039608,"version":"build-2803163510"},"reference-count":22,"publisher":"American Society of Hematology","issue":"18","license":[{"start":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T00:00:00Z","timestamp":1659657600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,11,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Acquired hemophilia A (AHA) is a rare severe autoimmune bleeding disorder with significant morbidity and mortality. Although critical for disease control, there is no consensus for the best immunosuppressive regimen. Most authors use steroids first line, followed by other agents for steroid failures. Upfront combined regimens offer the advantage of reduced steroid exposure and toxicity as well as increased efficacy. We retrospectively analyzed data from 32 patients with AHA treated on an identical such institutional protocol: cyclophosphamide 1000 mg on days 1 and 22, dexamethasone 40\u00a0mg on days 1, 8, 15, and 22, and rituximab 100 mg on days 1, 8, 15, and 22 (the regimen was termed CyDRi). All patients received at least 1 cycle of CyDRi. If necessary, CyDRi was repeated until remission, no sooner\u00a0than day 43 of the previous cycle. Bleeding control was rapidly achieved. The median time for bleeding control was 15.5 days (range, 0-429 days; interquartile range, 2.5-29.5 days). Thirty-one (96.8%) of 32 patients achieved durable complete remission (CR); 29\u00a0(90.6%) of 32\u00a0patients were alive at last follow-up, all of them in CR. The median time to reach first CR was 77 days (range, 19-939 days; interquartile range, 31-115 days). Toxicity and side effects were acceptable and milder than those of commonly used, prolonged steroid therapies. In conclusion, the CyDRi regimen produced markedly higher CR rates and overall survival than currently used sequential regimens. Taken together, CyDRi proved to be an attractive option for the immunosuppression of elderly patients with AHA.<\/jats:p>","DOI":"10.1182\/blood.2022016873","type":"journal-article","created":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T19:56:29Z","timestamp":1659729389000},"page":"1983-1992","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":32,"title":["Combined immunosuppression for acquired hemophilia A: CyDRi is a highly effective low-toxicity regimen"],"prefix":"10.1182","volume":"140","author":[{"given":"Barbara","family":"Simon","sequence":"first","affiliation":[{"name":"1Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Cegl\u00e9di","sequence":"additional","affiliation":[{"name":"2Department of Hematology and Stem Cell Transplantation, South-Pest Central Hospital, National Institute of Hematology and Infectious Disease, St. L\u00e1szl\u00f3 Campus, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e1nos","family":"Dolgos","sequence":"additional","affiliation":[{"name":"2Department of Hematology and Stem Cell Transplantation, South-Pest Central Hospital, National Institute of Hematology and Infectious Disease, St. L\u00e1szl\u00f3 Campus, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"Farkas","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manila","family":"Gaddh","sequence":"additional","affiliation":[{"name":"3Department of Hematology and Medical Oncology, Emory University, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e1szl\u00f3","family":"Hank\u00f3","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Horv\u00e1th","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9897-8936","authenticated-orcid":false,"given":"Ambrus","family":"Kaposi","sequence":"additional","affiliation":[{"name":"4ELTE, Faculty of Informatics, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e1szl\u00f3n\u00e9","family":"Magyar","sequence":"additional","affiliation":[{"name":"2Department of Hematology and Stem Cell Transplantation, South-Pest Central Hospital, National Institute of Hematology and Infectious Disease, St. L\u00e1szl\u00f3 Campus, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tam\u00e1s","family":"Masszi","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3474-2347","authenticated-orcid":false,"given":"Attila","family":"Szederjesi","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolett","family":"Wohner","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine and Hematology, Semmelweis University, Budapest, 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