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Successful Management of Natalizumab-Associated Primary Central Nervous System Lymphoma through Autologous Stem Cell Transplant
Natalizumab is used as a second-line treatment for multiple sclerosis (MS). Some reports have linked natalizumab to primary central nervous system lymphoma (PCNSL), although few have described its management. A 45-year-old woman with Balo’s Concentric Sclerosis presented dizziness, vertigo accompani...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816184/ https://www.ncbi.nlm.nih.gov/pubmed/33704187 http://dx.doi.org/10.3390/curroncol28010022 |
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author | Moineau-Vallée, Karine Rinfret, Justine Luu Hoai, My Hanh St-Louis, Valérie Berthelet, France Létourneau-Guillon, Laurent Lemieux-Blanchard, Émilie Prat, Alexandre Adam, Jean-Philippe |
author_facet | Moineau-Vallée, Karine Rinfret, Justine Luu Hoai, My Hanh St-Louis, Valérie Berthelet, France Létourneau-Guillon, Laurent Lemieux-Blanchard, Émilie Prat, Alexandre Adam, Jean-Philippe |
author_sort | Moineau-Vallée, Karine |
collection | PubMed |
description | Natalizumab is used as a second-line treatment for multiple sclerosis (MS). Some reports have linked natalizumab to primary central nervous system lymphoma (PCNSL), although few have described its management. A 45-year-old woman with Balo’s Concentric Sclerosis presented dizziness, vertigo accompanied by dysarthria, weakness on the left side and blurred vision to the right eye after the fourth dose of natalizumab. Magnetic resonance imaging (MRI) and a brain biopsy confirmed the diagnosis of PCNSL. The patient received modified PCNSL chemotherapy (MATRix protocol) followed by high-dose chemotherapy (HDC) supported by an autologous hematopoietic stem cell transplant (ASCT) as a consolidation therapy. Thirty months later, she is still in complete remission of her PCNSL and MS. In this case, whole brain radiotherapy was excluded because it may be associated with an increased risk of neurotoxicity in MS. ASCT was preferred because it has been shown to prevent disability progression in less advanced MS stages. Our patient is the second to receive an ASCT in this context and this option of treatment should be the preferred if the patient is eligible. |
format | Online Article Text |
id | pubmed-7816184 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-78161842021-01-27 Successful Management of Natalizumab-Associated Primary Central Nervous System Lymphoma through Autologous Stem Cell Transplant Moineau-Vallée, Karine Rinfret, Justine Luu Hoai, My Hanh St-Louis, Valérie Berthelet, France Létourneau-Guillon, Laurent Lemieux-Blanchard, Émilie Prat, Alexandre Adam, Jean-Philippe Curr Oncol Case Report Natalizumab is used as a second-line treatment for multiple sclerosis (MS). Some reports have linked natalizumab to primary central nervous system lymphoma (PCNSL), although few have described its management. A 45-year-old woman with Balo’s Concentric Sclerosis presented dizziness, vertigo accompanied by dysarthria, weakness on the left side and blurred vision to the right eye after the fourth dose of natalizumab. Magnetic resonance imaging (MRI) and a brain biopsy confirmed the diagnosis of PCNSL. The patient received modified PCNSL chemotherapy (MATRix protocol) followed by high-dose chemotherapy (HDC) supported by an autologous hematopoietic stem cell transplant (ASCT) as a consolidation therapy. Thirty months later, she is still in complete remission of her PCNSL and MS. In this case, whole brain radiotherapy was excluded because it may be associated with an increased risk of neurotoxicity in MS. ASCT was preferred because it has been shown to prevent disability progression in less advanced MS stages. Our patient is the second to receive an ASCT in this context and this option of treatment should be the preferred if the patient is eligible. MDPI 2020-12-30 /pmc/articles/PMC7816184/ /pubmed/33704187 http://dx.doi.org/10.3390/curroncol28010022 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Moineau-Vallée, Karine Rinfret, Justine Luu Hoai, My Hanh St-Louis, Valérie Berthelet, France Létourneau-Guillon, Laurent Lemieux-Blanchard, Émilie Prat, Alexandre Adam, Jean-Philippe Successful Management of Natalizumab-Associated Primary Central Nervous System Lymphoma through Autologous Stem Cell Transplant |
title | Successful Management of Natalizumab-Associated Primary Central Nervous System Lymphoma through Autologous Stem Cell Transplant |
title_full | Successful Management of Natalizumab-Associated Primary Central Nervous System Lymphoma through Autologous Stem Cell Transplant |
title_fullStr | Successful Management of Natalizumab-Associated Primary Central Nervous System Lymphoma through Autologous Stem Cell Transplant |
title_full_unstemmed | Successful Management of Natalizumab-Associated Primary Central Nervous System Lymphoma through Autologous Stem Cell Transplant |
title_short | Successful Management of Natalizumab-Associated Primary Central Nervous System Lymphoma through Autologous Stem Cell Transplant |
title_sort | successful management of natalizumab-associated primary central nervous system lymphoma through autologous stem cell transplant |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816184/ https://www.ncbi.nlm.nih.gov/pubmed/33704187 http://dx.doi.org/10.3390/curroncol28010022 |
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