Patient description: A 27-year-old woman at 11 weeks gestation in her second pregnancy is found to have a hemoglobin (Hb) of 9.0 g/dL, white blood cell count 6.3 x 109/L, platelet count 119 x 109/L, mean corpuscular volume 109 fL. Further investigations reveal mild iron deficiency. She already receives iron supplementation. The obstetrician repeats the complete blood cell count 2 weeks later. The Hb is 8.9 g/dL, WBC count 7.1 x 109/L, and platelets 108 x 109/L. She describes difficulty swallowing. A reticulocyte count is performed and found elevated at 180 x 109/L. The obstetrician requests a hematology consult. The following additional results were found: Negative DAT, normal clotting screen, elevated LDH (2000 IU/L), normal urea and electrolytes, normal alanine aminotransferase (ALT), anisocytosis, poikilocytosis, no fragments, no agglutination, polychromasia and presence of hemosiderin in the urine.

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Warm Autoimmune Hemolytic Anemia Age > 18 years AIHA defined at time of diagnosis by a Hgb level £ 10 g/dL, with a reticulocytes count > 120 109/L, signs of hemolysis (at least a haptoglobin level < 4 mg/L), and a positive direct antiglobulin test (DAT) ( IgG or IgG + complement pattern) Disease duration equal or less than 6 weeks at time of --> removed by amendment n°4 and substituted by :First episode of AIHA to "hot" antibody previously untreated or treated corticosteroids for less than 6 weeks Patients with an associated autoimmune thrombocytopenia (Evans' syndrome) will be eligible for the study if the platelet count is over 30 x 109/L at inclusion Normal level gammaglobulins in the serum (i.e. >5g/L) at inclusion Absence of detectable lymph nodes on a total body CT-scan (to be performed before if not performed at diagnosis) Effective means of contraception during treatment and for six months after completion of treatment for all women of child bearing age Negative serum pregnancy test within 14 days prior to study entry Written informed consent  Previous treatment with rituximab AIHA diagnosed and treated more than 6 weeks prior to removed by amendment n°4 and substituted by AIHA relapsed or newly diagnosed but treated with corticosteroids for more than 6 weeks Ongoing immunosuppressive therapy (other than corticosteroids) or previous treatment administered within 2 weeks prior to the beginning of the study treatment Non-Hodgkin Lymphoma (NHL) other than stage A chronic lymphoid leukemia Previous or concomitant malignancy other than basal cell or squamous cell carcinoma of the skin, carcinoma-in-situ of the cervix, or other malignancy for which the patient had not been disease-free for at least 5 years Autoimmune disorder such as SLE with at least one extra-hematological manifestation requiring a treatment with steroids and/or immunosuppressive drugs Any other associated cause congenital or acquired hemolytic anemia (except thalassemia trait or heterozygous sickle cell anemia) Negative DAT or DAT positive with isolated anti-C3d pattern related to the presence of a monoclonal IgM with cold agglutinin properties Positive HIV test and/or hepatitis virus C infection and/or positive hepatitis B virus surface antigen (HbsAg) Neutrophils count < 1,000/mm 3 at inclusion