Lack of CD4+ T cell percent decrease in alemtuzumab-treated multiple sclerosis patients with persistent relapses

Simona Rolla; Stefania Federica De Mercanti; Valentina Bardina; Dana Horakova; Mario Habek; Ivan Adamec; Eleonora Cocco; Pietro Annovazzi; Anton Vladic; Francesco Novelli; Luca Durelli; Marinella Clerico

doi:10.1016/j.jneuroim.2017.10.009

Lack of CD4+ T cell percent decrease in alemtuzumab-treated multiple sclerosis patients with persistent relapses

J Neuroimmunol. 2017 Dec 15:313:89-91. doi: 10.1016/j.jneuroim.2017.10.009. Epub 2017 Oct 17.

Affiliations

¹ Clinical and Biological Sciences Department, University of Torino, San Luigi Gonzaga Hospital, Orbassano (TO), Italy.
² Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University, General University Hospital, Czech Republic.
³ Department of Neurology, Referral Center for Autonomic Nervous System, University Hospital Center, University of Zagreb, School of Medicine, Zagreb, Croatia.
⁴ Multiple Sclerosis Center, Department of Medical Science and Public Health, University of Cagliari, Italy.
⁵ Multiple Sclerosis Study Center, AO S. Antonio Abate, Gallarate (VA), Italy.
⁶ Department of Neurology, Clinical Hospital Sveti Duh Zagreb, Medical Faculty University, J.J. Strossmayer, Osijek, Croatia.
⁷ Center for Experimental Research and Medical Studies (CERMS), Azienda Ospedaliera Città della Salute e della Scienza di Torino, Italy.
⁸ Clinical and Biological Sciences Department, University of Torino, San Luigi Gonzaga Hospital, Orbassano (TO), Italy. Electronic address: [email protected].

PMID: 29153614
DOI: 10.1016/j.jneuroim.2017.10.009

Abstract

Alemtuzumab, a highly effective treatment for relapsing remitting multiple sclerosis (RRMS), induces lymphopenia especially of CD4+ T cells. Here, we report the atypical CD4+ T population behaviour of two patients with persistent disease activity despite repeated alemtuzumab treatments. Whereas lymphocytes count decreased and fluctuated accordingly to alemtuzumab administration, their CD4+ cell percentage was not or just mildly affected and was slightly below the lowest normal limit already before alemtuzumab. These cases anticipate further studies aimed to investigate whether the evaluation of the CD4+ cell percentage could represent a helpful tool to address the individual clinical response to alemtuzumab.

Keywords: Alemtuzumab; CD4+ lymphocytes; Immune reconstitution; Multiple sclerosis; Treatment response.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Alemtuzumab / therapeutic use*
Antineoplastic Agents, Immunological / therapeutic use*
CD4-Positive T-Lymphocytes / drug effects*
CD4-Positive T-Lymphocytes / pathology*
Female
Humans
Multiple Sclerosis / drug therapy*

Substances

Antineoplastic Agents, Immunological
Alemtuzumab