Rigal J, Biotti D, Lépine Z, Ciron J
Department of Neurology, University Hospital of Toulouse, 31059 Toulouse cedex 9, France.
Department of Neurology, University Hospital of Toulouse, 31059 Toulouse cedex 9, France; Centre de Ressources et de Compétences Sclérose en plaques, University Hospital of Toulouse, 31059 Toulouse cedex 9, France; Inserm UMR1291 - CNRS UMR5051, University Toulouse 3, University Hospital of Toulouse, 31024 Toulouse cedex 3, France.
Rev Neurol (Paris). 2022 Mar;178(3):253-255. doi: 10.1016/j.neurol.2021.06.007. Epub 2021 Sep 24.
Late-onset neutropenia (LON) after anti-CD20 therapy is a poorly described side effect in inflammatory disorders of the CNS. In this prospective study, patients treated with Rituximab or Ocrelizumab for MS, neuromyelitis optica spectrum disorders or MOG antibody-associated disease (MOGAD) were asked to perform complete blood count (CBC) every two weeks for six months, with the aim of identifying LON. Out of 152 patients, two (1,32%) had an absolute neutrophil count <1,000/mm: one patient with MOGAD had agranulocytosis and one patient with MS had grade 3 neutropenia. Both were asymptomatic. These results confirm that LON after anti-CD20 therapy in inflammatory disorders of the CNS is not exceptional. Nevertheless, this biological complication remains too infrequent to justify close systematic CBC follow-up.
抗CD20治疗后出现的迟发性中性粒细胞减少症（LON）在中枢神经系统炎性疾病中是一种描述较少的副作用。在这项前瞻性研究中，接受利妥昔单抗或奥瑞珠单抗治疗多发性硬化症、视神经脊髓炎谱系障碍或MOG抗体相关疾病（MOGAD）的患者被要求每两周进行一次全血细胞计数（CBC），持续六个月，目的是识别LON。在152名患者中，有两名（1.32%）的绝对中性粒细胞计数<1000/mm³：一名患有MOGAD的患者出现粒细胞缺乏症，一名患有多发性硬化症的患者出现3级中性粒细胞减少症。两人均无症状。这些结果证实，在中枢神经系统炎性疾病中，抗CD20治疗后出现LON并非罕见。然而，这种生物学并发症仍然很少见，不值得进行密切的系统性CBC随访。
