Cellular immune suppression in paraneoplastic neurologic syndromes targeting intracellular antigens.

Archives of Neurology
Dana OrangeRobert B Darnell

Abstract

BACKGROUND Tumor treatment is the mainstay of therapy for paraneoplastic neurologic disorders (PNDs), but it is only effective in some cases and other treatment options are limited. OBJECTIVE To evaluate the short-term use of a combination of prednisone and tacrolimus for acute neurologic worsening in PND in which intracellular antigens are targeted. DESIGN Retrospective single-center case series of patients with PND treated with tacrolimus. SETTING The Rockefeller University Hospital, a research hospital in New York, New York. PATIENTS Twenty-six patients with PND with high titer (≥1:1000) anti-HuD, anti-Yo, or anti-CRMP5 autoantibodies were enrolled. Patients were referred from Memorial Sloan Kettering Cancer Center or self-referred. Two patients discontinued intervention owing to adverse events. INTERVENTIONS Patients were treated with tacrolimus, 0.15-0.30 mg/kg per day, in 2 divided oral doses with 60 mg per day of oral prednisone, tapered off during 1 to 4 weeks. MAIN OUTCOME MEASURES The primary outcome measure was median survival. Neurologic examinations before and after treatment as well as adverse events are described. RESULTS Median survival time was 52 months from time of diagnosis. Some patients experienced neurolo...Continue Reading

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Citations

Sep 23, 2014·Current Problems in Cancer·Samuel MartelGiovanna Speranza
Mar 23, 2013·Annual Review of Immunology·B DiamondB T Volpe
Feb 26, 2013·Current Treatment Options in Neurology·Aurélien Viaccoz, Jérôme Honnorat
Dec 30, 2014·Clinical and Experimental Immunology·M C Dalakas, W N Löscher
Nov 29, 2012·Neurologic Clinics·Giuseppe CiccotoRoger E Kelley
Aug 1, 2015·Annals of Neurology·Wendy K RobertsRobert B Darnell
Oct 24, 2015·Trends in Immunology·Lior BrimbergBetty Diamond
Oct 21, 2016·Annals of Neurology·Wendy K RobertsRobert B Darnell
Feb 16, 2018·Current Neurology and Neuroscience Reports·Sonal Bhatia, Sarah E Schmitt
Apr 22, 2018·Neuropathology and Applied Neurobiology·D PanjaM Schubert
Mar 22, 2018·Reviews in the Neurosciences·Karolina Popławska-DomaszewiczSławomir Michalak
Jan 15, 2013·Current Treatment Options in Neurology·John E Greenlee
Aug 27, 2015·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Richard M RansohoffAmit Bar-Or
Apr 3, 2021·Therapeutic Advances in Neurological Disorders·Michelle F DevineDivyanshu Dubey

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