Would you retry rituximab in steroid refractory warm autoimmune hemolytic anemia which responded to rituximab before?

Yes, I would utilize rituximab a second time for treatment of AIHA in light of a response during the first episode. The first response was not that durable in this case, and it would be anticipated the response after the second round of rituximab may not be even as durable as the first. As usual with AIHA, a trial of steroids is first indicated even in recurrence, but given that rituximab was utilized the first time, it is assumed that an optimal response to steroids or steroids + rituximab did not occur or that there were side effects or contraindications to their long-term use and eventual taper. In AIHA, other modalities such as IVIG, cyclophosphamide, mycophenolate mofetil, azathioprine, and a host of other agents have a chance of respo...