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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
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.
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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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