Ofatumumab for a rituximab-allergic child with chronic-relapsing paraneoplastic opsoclonus-myoclonus.

Abstract

Ofatumumab is a fully human anti-CD20 monoclonal antibody in phase II-III trials for various autoimmune and lymphoreticular diseases. We used it to treat a rituximab-allergic child with severe, chronic-relapsing, opsoclonus-myoclonus syndrome (OMS), characterized by persistent cerebrospinal fluid (CSF) B-cell expansion and T-cell dysregulation. He had relapsed despite chemotherapy, plasma exchange with immunoadsorption, and resection of ganglioneuroblastoma, detected 3 years after OMS onset. The four ofatumumab infusions (1,195 mg/m(2) total dose) were well tolerated, and CSF B-cell expansion was eliminated. No further relapses have occurred in 3 years, but he remains on low-dose ACTH with neuropsychiatric residuals of OMS.

• Authors: Michael R Pranzatelli, Elizabeth D Tate, Shalini Shenoy, Anna L Travelstead
• Journal: Pediatric blood & cancer (Pediatr Blood Cancer) Vol. 58 Issue 6 Pg. 988-91 (Jun 2012) ISSN: 1545-5017 [Electronic] United States
• PMID: 21618414 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Wiley Periodicals, Inc.

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Antibodies, Monoclonal, Murine-Derived
• Rituximab
• ofatumumab

Topics

• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Humanized
• Antibodies, Monoclonal, Murine-Derived (adverse effects, immunology)
• Drug Hypersensitivity (etiology)
• Ganglioneuroblastoma (complications)
• Humans
• Infant
• Male
• Opsoclonus-Myoclonus Syndrome (drug therapy, etiology, physiopathology)
• Rituximab
• Spinal Cord Neoplasms (complications)