Weinstock-Guttman Bianca, Ramanathan Murali, Lincoff Norah, Napoli Salvatore Q, Sharma Jitendra, Feichter Joan, Bakshi Rohit
The William C. Baird Multiple Sclerosis Center, Jacobs Neurological Institute, State University of New York, Buffalo, NY 14203, USA.
Arch Neurol. 2006 Jul;63(7):957-63. doi: 10.1001/archneur.63.7.957.
Neuromyelitis optica is a severe demyelinating disease that selectively involves the optic nerves and the spinal cord but usually spares the brain. It is considered to have a B-cell-induced pathogenesis. Mitoxantrone hydrochloride, a synthetic anthracenedione approved for worsening relapsing-remitting multiple sclerosis and secondary progressive multiple sclerosis, has been shown to primarily suppress the humoral response.
To evaluate the benefit of mitoxantrone treatment in patients with relapsing neuromyelitis optica.
Prospective 2-year study.
Academic multiple sclerosis center.
Five patients (3 women and 2 men) with an age range of 20 to 51 years and an Expanded Disability Status Scale score of 2.5 to 6.5 (mean +/- SD, 4.40 +/- 1.88).
Monthly intravenous infusions of mitoxantrone hydrochloride, 12 mg/m2, for 6 months followed by 3 additional treatments every 3 months.
Expanded Disability Status Scale score measured every 3 months and during relapses; findings on orbital, brain, and spinal cord magnetic resonance images performed at baseline and at 3, 6, 12, 18, and 24 months; and visual evoked potentials and results of ophthalmologic evaluations performed at baseline and annually.
During the 2 years of treatment, 2 patients each had a relapse once within the initial 5 months of treatment (1 severe and 1 moderate). Improvement was seen clinically and on magnetic resonance images in 4 patients. Patients generally tolerated the treatment well, although 1 patient had a reversible decrease in cardiac ejection fraction.
Our results suggest a beneficial effect of mitoxantrone treatment for relapsing neuromyelitis optica.
视神经脊髓炎是一种严重的脱髓鞘疾病，选择性累及视神经和脊髓，但通常不累及大脑。它被认为具有B细胞介导的发病机制。盐酸米托蒽醌是一种已被批准用于治疗复发缓解型多发性硬化症和继发进展型多发性硬化症病情恶化的合成蒽二酮，已被证明主要抑制体液免疫反应。
评估盐酸米托蒽醌治疗复发型视神经脊髓炎患者的疗效。
前瞻性2年研究。
学术性多发性硬化症中心。
5例患者（3例女性和2例男性），年龄范围为20至51岁，扩展残疾状态量表评分为2.5至6.5（平均值±标准差，4.40±1.88）。
每月静脉输注盐酸米托蒽醌，剂量为12 mg/m²，共6个月，随后每3个月再进行3次治疗。
每3个月及复发时测量扩展残疾状态量表评分；在基线、3、6、12、18和24个月时进行眼眶、脑和脊髓磁共振成像检查结果；在基线和每年进行视觉诱发电位及眼科评估结果。
在2年的治疗期间，2例患者在治疗的最初5个月内各复发1次（1例严重，1例中度）。4例患者在临床和磁共振成像上有改善。患者对治疗的耐受性一般良好，尽管1例患者的心脏射血分数出现可逆性下降。
我们的结果表明盐酸米托蒽醌治疗复发型视神经脊髓炎有有益效果。
