Rituximab for polyneuropathy with IgM monoclonal gammopathy.
J Neurol Neurosurg Psychiatry
; 80(9): 1036-9, 2009 Sep.
Article
em En
| MEDLINE
| ID: mdl-19684235
ABSTRACT
BACKGROUND:
Polyneuropathy with IgM monoclonal gammopathy can be a disabling disorder necessitating treatment.METHODS:
In a prospective open label trial, 17 patients with disabling IgM MGUS polyneuropathy were treated with rituximab, a chimeric anti-CD-20 monoclonal antibody.RESULTS:
Rituximab induced an improvement of >or=1 point on the Overall Disability Sum Score in 2/17 patients, an improvement of >or=5% of the distal MRC sum score in 4/17 and the sensory sum score in 9/17 patients. Bone marrow investigations showed CD 20 B cell depletion in all patients. There were no serious adverse events. Compared with treatment with intermittent cyclophosphamide with prednisone or treatment with fludarabine, it shows a comparable response percentages but fewer side effects. The presence of anti-MAG and a disease duration shorter than 10 years may predict treatment response.CONCLUSION:
Rituximab is a candidate for treatment of IgM MGUS polyneuropathy and should be further investigated in a double-blind randomised trial.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Paraproteinemias
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Imunoglobulina M
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Fatores Imunológicos
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Anticorpos Monoclonais
Tipo de estudo:
Clinical_trials
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2009
Tipo de documento:
Article