| Rituximab therapy in monoclonal IgM-related neuropathies. | |
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MedLine Citation:
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PMID: 16753870 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Monoclonal IgM-related neuropathies constitute a heterogeneous group of disorders, which are generally poorly responsive to treatment. Rituximab, a chimeric monoclonal antibody against the CD20 molecule, has been used with success in patients with neuropathy and monoclonal IgM with anti-MAG or anti-GM1 ganglioside activity. Based on this observation, four patients were treated with IgM-related neuropathy with rituximab. Between January 1999 - December 2000, four patients with IgM-related neuropathy (one with chronic inflammatory demyelinating polyneuropathy (CIDP) and three with sensorimotor demyelinating neuropathy) were treated with rituximab. Rituximab was administered at a standard dose of 375 mg m(-2) iv weekly for a consecutive 4 weeks; 3 months later, four additional weekly courses were administered to patients who did not experience deterioration of their neuropathy symptoms. Neurological evaluation was performed before each rituximab infusion and at 1 week and 2 months after last infusion and every 6 months the following years; including motor (MRC in six muscle groups, 9-hole peg test, 10 m walk, hand grip strength), sensory neuropathy (vibration threshold and sensory subjective score) assessment. Neurophysiological parameters were also assessed (MNCV, SNCV, CMAP, SNAP). Strength improved in three of four patients; including the patient with CIDP. This patient developed a significant worsening of her weakness 3 weeks after the initiation of rituximab. This phenomenon coincided with a serum monoclonal IgM flare and resolved spontaneously 1 week later. Her improvement is ongoing for more than 5 years. Considering neurophysiological parameters, two patients showed a slight improved regarding conduction velocities and CMAP (10%) and the patient with IgM flare had a transient worsening of conduction velocities followed by improvement. In conclusion, rituximab is a safe and well-tolerated treatment which may be effective in some patients with IgM-related neuropathy. |
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Authors:
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Constantinos Kilidireas; Athanasios Anagnostopoulos; Nikolaos Karandreas; Lefki Mouselimi; Meletios-Athanasios Dimopoulos |
Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Leukemia & lymphoma Volume: 47 ISSN: 1042-8194 ISO Abbreviation: Leuk. Lymphoma Publication Date: 2006 May |
Date Detail:
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Created Date: 2006-06-06 Completed Date: 2006-10-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9007422 Medline TA: Leuk Lymphoma Country: England |
Other Details:
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Languages: eng Pagination: 859-64 Citation Subset: IM |
Affiliation:
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Department of Neurology, Eginition Hospital, Greece. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Antibodies, Monoclonal / administration & dosage* Demyelinating Diseases / diagnosis, drug therapy Humans Immunoglobulin M* / blood Middle Aged Muscle Weakness Peripheral Nervous System Diseases / diagnosis, drug therapy* Sensation Disorders Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Monoclonal; 0/Immunoglobulin M; 0/rituximab |
| Comments/Corrections | |
Comment In:
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Leuk Lymphoma. 2006 May;47(5):785-6
[PMID:
16753860
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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