Efficacy and Safety of Mitoxantrone in Patients With Highly Relapsing Neuromyelitis Optica
2010; American Medical Association; Volume: 68; Issue: 4 Linguagem: Inglês
10.1001/archneurol.2010.322
ISSN1538-3687
AutoresSu‐Hyun Kim, Woojun Kim, Min Su Park, Eun Hee Sohn, Xue Feng Li, Ho Jin Kim,
Tópico(s)Acute Lymphoblastic Leukemia research
ResumoTo evaluate the efficacy and safety of mitoxantrone hydrochloride and determine how it exhibits a differential inhibitory effect on subsets of B cells in patients with highly relapsing neuromyelitis optica (NMO).Retrospective case series with prospective follow-up.Three referral medical centers in the Republic of Korea.Twenty patients with highly relapsing NMO or neuromyelitis optica spectrum disorder who had at least 2 relapses during the year preceding the start of mitoxantrone treatment, despite other immunotherapies.Infusions of mitoxantrone up to a maximum cumulative dose of 120 mg/m(2).Annualized relapse rate, disability according to the Expanded Disability Status Scale score, and fraction of CD27(+)CD19(+) memory B cells.During mitoxantrone treatment, the median annualized relapse rate was reduced by 75%, and 50% of patients became relapse free. Disability improved or stabilized in all patients. No patients had serious adverse effects during the mean follow-up period of 41 months after completing therapy. Flow cytometric analysis of cell surface markers revealed that mitoxantrone treatment preferentially affected CD27(+)CD19(+) memory B cells.Treatment with mitoxantrone in patients with highly relapsing NMO significantly reduces relapse rates, resulting in subsequent functional stabilization or improvement.
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