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Activation of disease during therapy with alemtuzumab in 3 patients with multiple sclerosis.

Authors
  • Wehrum, Thomas1
  • Beume, Lena-Alexandra2
  • Stich, Oliver2
  • Mader, Irina2
  • Mäurer, Mathias2
  • Czaplinski, Adam2
  • Weiller, Cornelius2
  • Rauer, Sebastian2
  • 1 From the Departments of Neurology and Neuroscience (T.W., L.-A.B., O.S., C.W., S.R.) and Neuroradiology (I.M.), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg; Department of Neurology (M.M.), Stiftung Juliusspital Würzburg, Germany; and Neurozentrum Bellevue (A.C.), Zürich, Switzerland. [email protected] , (Switzerland)
  • 2 From the Departments of Neurology and Neuroscience (T.W., L.-A.B., O.S., C.W., S.R.) and Neuroradiology (I.M.), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg; Department of Neurology (M.M.), Stiftung Juliusspital Würzburg, Germany; and Neurozentrum Bellevue (A.C.), Zürich, Switzerland. , (Switzerland)
Type
Published Article
Journal
Neurology
Publisher
Ovid Technologies (Wolters Kluwer) - American Academy of Neurology
Publication Date
Feb 13, 2018
Volume
90
Issue
7
Identifiers
DOI: 10.1212/WNL.0000000000004950
PMID: 29352101
Source
Medline
License
Unknown

Abstract

This is a case series reporting severe activation of disease during immunotherapy with alemtuzumab. All patients showed onset of symptoms 6 months after induction of alemtuzumab, strikingly similar MRI lesion morphology, and unexpected high total B cell count, which may suggest a B-cell-mediated activation of disease. Whether this is due to different rates of B- and T cell repopulation has to be the subject of further research. Moreover, further effects on the interactions between the adaptive and innate immunity as well as between B and T cell lineages might explain the observed disease activation.

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