Multiple Sclerosis Center "A. Cardarelli "Hospital, Naples, Italy; Neurological Clinic and Stroke Unit "A. Cardarelli "Hospital, Naples, Italy.
Hematology Unit "A. Cardarelli "Hospital, Naples, Italy.
Mult Scler Relat Disord. 2020 Aug;43:102151. doi: 10.1016/j.msard.2020.102151. Epub 2020 May 3.
Cladribine tablets were recently approved for the treatment of Relapsing-Remitting Multiple Sclerosis (RRMS), reducing B cells and T cells, followed by reconstitution of the adaptive immune system, with transient and mild effects on the innate one. Cladribine is also the standard first-line and subsequent treatment for Hairy-Cell Leukemia (HCL), frequently complicated by neutropenic fever. Recombinant human Granulocyte Colony-Stimulating Factor (G-CSF; Filgrastim) has been proved to reduce neutropenia by increasing neutrophil count.
To the best of our knowledge, we report the first case of early and persistent high grade non febrile neutropenia after oral cladribine therapy in a 49-year-old RR-MS patient, successfully treated with Filgrastim.
This report suggests that in selected cases, cladribine requires early monitoring of blood sample as it may be responsible for early neutropenia, requiring specific treatment.
克拉屈滨片最近被批准用于治疗复发缓解型多发性硬化症（RRMS），通过减少 B 细胞和 T 细胞，随后重建适应性免疫系统，对固有免疫系统产生短暂和轻微的影响。克拉屈滨也是治疗毛细胞白血病（HCL）的标准一线和后续治疗药物，常伴有中性粒细胞减少性发热。重组人粒细胞集落刺激因子（G-CSF；非格司亭）已被证明通过增加中性粒细胞计数来减少中性粒细胞减少症。
据我们所知，我们报告了首例 49 岁 RR-MS 患者口服克拉屈滨治疗后出现早期和持续的高级别非发热性中性粒细胞减少症的病例，该患者使用非格司亭成功治疗。
本报告表明，在某些情况下，克拉屈滨需要早期监测血液样本，因为它可能导致早期中性粒细胞减少症，需要特定的治疗。
