Abstract Details

Title Acquired Demyelinating Neuropathy Associated with Use of Brentuximab

Topic Peripheral Nerve

Presentation(s) P07 - (-)

Poster/Presentation
Number 053

Objective

Background BACKGROUND: Brentuximab is a monoclonal antibody used for the treatment of refractory hematological malignancies. Monoclonal antibodies such as infliximab and adalimumab have been reported to be associated with demyelinating neuropathy. Demyelinating neuropathy associated with Brentuximab has not been reported.

Design/Methods DESIGN/METHODS: Retrospective review of medical records, laboratory and EMG findings.

Results RESULTS: A 64 year old male with stage IV Hodgkin's lymphoma developed numbness in hands and feet 5 months after initiation of Brentuximab (after 7th of planned 16 cycles). He was diagnosed in 2008 and treated with 6 cycles of adriamycin, bleomycin, vinblastine and dacarbazine. He then underwent radiation to the left neck, 3 cycles of Ifosfamide, carboplatin, and etoposide followed by autologous stem cell transplantation in December 2010 for persistent/ recurrent disease. He was found to have second recurrence in September 2011 and was started on Brentuximab in October 2011. He responded well to Brentuximab. Once sensory symptoms developed in February 2012, Brentuximab was discontinued but patient got progressively weaker. Physical examination showed symmetrical, predominantly distal weakness with areflexia. There was distal limb sensory loss. Electrophysiological study showed an acquired demyelinating neuropathy. Cerebrospinal fluid analysis showed albuminocytologic dissociation. He was treated with intravenous corticosteroids with significant improvement in muscle strength and electrophysiological abnormalities.

Conclusions CONCLUSIONS: Brentuximab can potentially be associated with neurological complications, in this case, a demyelinating neuropathy. The neuropathy is potentially treatable with cessation of the agent and the use of intravenous corticosteroids. Further observational studies are required to estimate the true prevalence.

Authors/Disclosures
sreekanth koneru, MD (University of Texas Health Science Center) PRESENTER	Dr. Koneru has nothing to disclose.
	No disclosure on file
Pariwat Thaisetthawatkul, MD, FAAN (University of Nebraska Medical Center)	Dr. Thaisetthawatkul has nothing to disclose.
J. Americo M. Fernandes, Jr., MD, FAAN (University of Nebraska Medical Center)	Dr. Fernandes has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Columbia University. The institution of Dr. Fernandes has received research support from MGH philanthropy (Clene, Seelos, UCB, Biohaven, Prilenia, Denali Therapeutics, Calico Life Sciences. The institution of Dr. Fernandes has received research support from Columbia University. The institution of Dr. Fernandes has received research support from PTC Therapeutics. The institution of Dr. Fernandes has received research support from Clene.
Steve Kanes, MD, PhD (Sage Therapeutics)	Dr. Kanes has received personal compensation for serving as an employee of Sage Therapeutics. Dr. Kanes has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Verge Genomics. Dr. Kanes has received intellectual property interests from a discovery or technology relating to health care.

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