Efficacy and Safety of Mitoxantrone in Patients With Highly Relapsing Neuromyelitis Optica

Title
Efficacy and Safety of Mitoxantrone in Patients With Highly Relapsing Neuromyelitis Optica
Author(s)
박민수김수현[김수현]김우준[김우준]Xue Feng Li[Xue Feng Li]김호진[김호진]손은희[손은희]
Keywords
MULTIPLE-SCLEROSIS; IMMUNOCOMPETENT CELLS; IN-VITRO; THERAPY; INDUCTION; IMMUNOMODULATION; SUPPRESSION; INTERFERON; MECHANISM; RITUXIMAB
Issue Date
201012
Publisher
AMER MEDICAL ASSOC
Citation
ARCHIVES OF NEUROLOGY, v.68, no.4, pp.473 - 479
Abstract
Objective: To 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). Design: Retrospective case series with prospective follow-up. Setting: Three referral medical centers in the Republic of Korea. Patients: 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. Intervention: Infusions of mitoxantrone up to a maximum cumulative dose of 120 mg/m(2). Main Outcome Measures: Annualized relapse rate, disability according to the Expanded Disability Status Scale score, and fraction of CD27(+)CD19(+) memory B cells. Results: 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. Conclusions: Treatment with mitoxantrone in patients with highly relapsing NMO significantly reduces relapse rates, resulting in subsequent functional stabilization or improvement.
URI
http://hdl.handle.net/YU.REPOSITORY/23294http://dx.doi.org/10.1001/archneurol.2010.322
ISSN
0003-9942
Appears in Collections:
의과대학 > 신경과학교실 > Articles
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