This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
All are true about cold agglutinin disease, EXCEPT: 
Select and explain. 
A. Hemolysis is more prominent the more the body is exposed to the cold, B. The antibody is usually IgM with an anti-I specificity, C. Blood transfusion is not very effective because donor red cells are I-positive and will be rapidly removed, D. Rituximab is not effective as a therapeutic measure as it can not control hemolysis effectively
D: Rituximab is not effective as a therapeutic measure as it can not control hemolysis effectively
Answer: D: Rituximab is not effective as a therapeutic measure as it can not control hemolysis effectively 
Explanation: Cold Agglutinin Disease (CAD): Hemolysis is prominent when the body is exposed to the cold. The antibody is usually IgM with an anti-I specificity. Since the antibody is IgM, CAD is related to Waldenstrom macroglobulinemia. Blood transfusion is not effective because donor red cells are I-positive and will be rapidly removed. Rituximab is effective in treatment and Given the long clinical course of CAD, it remains to be seen with what periodicity rituximab will need to be administered. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 882.